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` SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ' � �':'• FILE NUMBER: PA- <br /> 9L%FOFit� <br /> Excavation Characteristics <br /> Excavation Area (Acres): Q, Fill Area(Acres): O <br /> Existing Site Elevation(Average at 100' Intervals): /7,-7 <br /> Proposed Site Elevation (Average at 100'Intervals): it" z <br /> Perimeter Elevation(Average at 100' Intervals, 100'from Property Line): <br /> Amount of Material to be Removed (Cubic Yards): S <br /> Will topsoil be replaced? Yes ❑ No )� <br /> If no,a soils report is required. <br /> Proposed method of Financial Guarantee: <br /> Z A Surety Bond <br /> ❑ A Trust Fund with the Community Development Department <br /> ❑ An Irrevocable Letter of Credit <br /> Approximate Start Date:UF0&1 AEOZEtJLApproximate End Date: <br /> Hours of Operation: '7,,#p #&verage Daily Truck Trips: <br /> Surface Transportation Assistance Act STAR trucks <br /> Will STAA type trucks,over California Legal length, be used as part of the proposed operation? <br /> Yes❑ (if yes,the applicant must provide a letter requesting designation of the proposed facility as an STAA terminal.) <br /> N <br /> AUTHORIZATION SIGNATURES i <br /> OWNER, OPERATOR AND APPLICANT INFORMATION AND SIGNATURES —� <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION_; <br /> Property owners or owners of surface rights list all owners <br /> Name::1G y�. Ad s: w� P CA 0442Z PIzo h e. '9f51,5�b� <br /> Signature: Date: <br /> Name: Address: Phone: <br /> Signature: Date: <br /> Name: Address: Phone: <br /> Signature: Date: <br /> Name: Address: Phone: <br /> Signature: Date: <br /> Name: Address: Phone: <br /> Signature: Date: <br /> Note: All Legal owners of the property(s) involved in this project or their legal agents must sign the application thereby <br /> verifying that the statements contained in the application are true and correct. If a legal agent signs the application on <br /> behalf of the property owner,written consent by the owner must accompany the application. <br /> POEVSMPlanning Application Forms\ Page 4 of 15 <br />