REV 1/5/2022
Canneble License Application Page 55 of 08
16. If this is an Institutional profect, Indicate the ma for function, estimated employment per shift, estimated occupency, loading facilkles, and community benefts to be derived from the profect N/A
17. If the project Involves a vartance, conditional use permit, or rezoning application, state this and Indicate clearty why the application is required:
Conditional Use Permits are required for all commercial cannabls projects.
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 exsting residential areas or public lands or roads.
X 20. Change in pattern, scale or character of general area of project.
21. Significant amounts of solld waste or litter.
22. Change in dust, ash, smole, fumes or odors in vicinity.
23. Change in lake, stream or ground water quality or quantity, or alteration of exsting drainaze patters.
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 explosives.
27. Substantial change In demand for municipal service (police, fire, water, sewage, etc.).
X 28. Substantially Increase fossil fuel consumption (electricity, oll, natural gas, etc.).
X 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, soll stability. plants and animals, and arry 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 polarold photos will be accepted.
31. On a separate page, describe the surrounding properties, Including Information on plants and animals and any cuftural, 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 polarold 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 no wedge and belief.
11/24/22
Signature: Date:
Nebrina Barstow LIC
For:
220E Mountain View St. Ste A • Barstow, CA 92311 • (760) 255-5161 • https://www.barstowca.org/home Scanned with CamScanner
arable Learns Arou • 54 м ве
REV 1/5/2022
HAZARDOUS WASTE AND SUBSTANCES STATEMENT
The development project and any alternatives proposed in thes application are contained on one of more of the fits of hazardous waste sites and facilites corr led pursuant to Section 65952.5 of the Goverment Code, Accordiner. the profect applicant is required to submit a ste red statement which contains the following Information:
1. Name of applicant: Nebrina Barstow LIC
2. Address: 2795 Lemwood Roed Perstor, CA 92311
3. Phone Number: 773-220-5786
A. Address of Site (street name and number if avallable, and ZP code):
2795 Lenwood Roed Barstow, CA 92311
S. Local Agency (city/county): Clty of Barstom / County of San Bernadino
6. Assessor's book, page, and parcel number: 042-131-346-0000
7. Specify any list pursuant to Section 65962.5 of the Government Code:
None
8. Regulatory Identification number: N/A
9. Date of List
BB 11124122
Date:
Signature:
Nebrina Barstow LIC
For: (Applicant)
220 E Mountain View St. Ste A • Barstow, CA 92311 • (760) 255-5161 • https://www.barstowca.ors/home Scanned with CamScanner