LIC-977-CNB Cannabis License Application Page 52 of 66
THE CITY OF
ENVIRONMENTAL
INFORMATION O BARSTOW
AND
CHECKLIST FORM
CROSSROADS OF OPPORTUNITY
(to be completed by applicant)
Date Filed: Planning Case No.
1. Developer or Project Sponsor:
Name: Quality Life Inc.
Address: 2841 Lenwood Rd., #2
City: Barstow State: CA Zip: 92311
2. Address of project:
2841 Lenwood Rd. #2, , Barstow, CA 92311
3. Assessor's Block and Lot Number : 0428-211-31-0000
4. Primary Project Contact
Name: Michael Wilhoit Phone: 760-447-1880
Address: 1305 W. Main Street Emall: [email protected] City: Barstow ] State: CA
1 Zip: 92311
5. List and describe any other related permits and other public approvals required for this project, including those required by city, regional, state and federal agencies:
Cannabis Storefront Business License from City of Barstow; California State Department of Cannabis Control Storefront License (type 10)
6. Existing zoning district: | Commercial
7. Proposed use of site (Project for which this form is filed):
Licensed cannabis retail storefront with delivery.
PROJECT DESCRIPTION
8. Site size: 20,000 square feet
9. Square footage: Our unit is 1563 sq. ft.
10. Number of floors of construction: ¡ One
11. Amount of off-street parking provided and number of employees per shift/total:
63 parking spaces: 2 shifts, 19 employees total. First shift: 8 employees; Second: 5 employees.
12. (Attach Plans)
13. Anticipated incremental development (i.e., phasing):
N/A.
14. If this is a commercial project, indicate the type of project, whether neighborhood, city or regionally oriented, square footage of sales area, and loading facilities:
Licensed cannabis storefront retailer, regionally oriented. Square footage of sales area is approximately 600 square feet.
15. If this is an industrial project, indicate the type of project, estimated employment per shift, and loading facilities:
N/A
220 E Mountain View St. Ste A • Barstow, CA 92311 • (760) 255-5161 • https://www.barstowca.org/home LIC-977-CNB
Cannabis License Application Page 53 of 66
16. If this is an institutional project, indicate the major function, estimated employment per shift, estimated occupancy, loading facilities, and community benefits to be derived from the project:
N/A
17. If the project involves a variance, conditional use permit, or rezoning application, state this and indicate clearly why the application is required:
Conditional Use Permit also required pursuant to Barstow Municipal Code.
Are the following items applicable to the project or its effects? Discuss below all items checked yes (attach additional sheets as necessary).
YES NO
18. Change in existing features of any hills, or substantial alteration of ground contours.
19. Change in scenic views or vistas from existing residential areas or public lands or roads.
20. Change in pattern, scale or character of general area of project.
21. Significant amounts of solid waste or litter.
22. Change in dust, ash, smoke, fumes or odors in vicinity.
23. Change in lake, stream or ground water quality or quantity, or alteration of existing drainage
24. Substantial change in existing noise or vibration levels in the vicinity.
25. Site on filled land or on slope of 10 percent or more.
26. Use or disposal of potentially hazardous materials, such as toxic substances, flammables or explasives.
27. Substantial change in demand for municipal service (police, fire, water, sewage, etc.).
28. Substantially increase fossil fuel consumption (electricity, oil, natural gas, etc.).
29. Relationship to a larger project or series of projects.
ENVIRONMENTAL SETTING
30. On a separate page, describe the project site as it exists before the project, including information on topography, soil stability, plants and animals, and any cultural, historical, or scenic aspects. Describe any existing structures on the site, and the use of the structures. Attach photographs of the site. Snapshots, digital or polaroid photos will be accepted.
31. On a separate page, describe the surrounding properties, including information on plants and animals and any cultural, historical, or scenic aspects. Indicate the type of land use (residential, commercial, etc.), intensity of land use (one-family, apartment houses, shops, department stores, etc.), and scale of development (height, frontage, set-back, rear yard, etc.). Attach photographs of the vicinity. Snapshots, digital or polaroid photos will be accepted.
NOTE: Before the Lead Agency can accept this application as complete, the applicant must consult the lists prepared pursuant to Section 65962.5 of the Government Code and submit a signed statement indicating whether the project and any alternatives are located on a site which is included on any such list, and shall specify any list.
CERTIFICATION
I hereby certify that the statements furnished above and in the attached exhibits present data and information required for this initial evaluation to the best of my ability, and that the facts, statements, and in formation presented are true and correct to the best of my knowledge and belief.
11.30.2021
Signature: Date:
QUALITY LIFE, InE.
For:
220 E Mountain View St. Ste A • Barstow, CA 92311 • (760) 255-5161 • https://www.barstowca.org/home LIC-977-CNB
Cannabis License Application Page 54 of 66
HAZARDOUS WASTE AND SUBSTANCES STATEMENT
The development project and any alternatives proposed in this application are contained on one or more of the lists of hazardous waste sites and facilities compiled pursuant to Section 65962.5 of the Government Code. Accordingly, the project applicant is required to submit a signed statement which contains the following information:
1. Name of applicant: Michael Wilhoit / Quality Life Inc.
2. Address: 1305 W. Main Street, Barstow, California 92311
3. Phone Number: 760-447-1880
4. Address of Site (street name and number if available, and ZIP code):
2841 Lenwood Rd., #2, Barstow, CA 92311
5. Local Agency (city/county): Barstow / San Bernardino
6. Assessor's book, page, and parcel number: 0428-211-31-0000
7. Specify any list pursuant to Section 65962.5 of the Government Code:
N/A
8. Regulatory identification number:
9. Date of List:
11.30. 2021
Signature: Date:
QUALITY LIFE, INC.
For: (Applicant)
220 E Mountain View St. Ste A • Barstow, CA 92311 • (760) 255-5161 • https://www.barstowca.org/home