220 E Mountain View St. Ste A • Barstow, CA 92311 • (760) 255-5161 • https://www.barstowca.org/home
ENVIRONMENTAL
INFORMATION
AND
CHECKLIST FORM
(to be completed by applicant)
Date Filed: _________________________________ Planning Case No. _______________________________
1. Developer or Project Sponsor:
Name:
Address:
City: State: Zip:
2. Address of project:
3. Assessor’s Block and Lot Number :
4. Primary Project Contact
Name: Phone:
Address: Email:
City: State: Zip:
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:
6. Existing zoning district:
7. Proposed use of site (Project for which this form is filed):
PROJECT DESCRIPTION
8. Site size:
9. Square footage:
10. Number of floors of construction:
11. Amount of off-street parking provided and number of employees per shift/total:
12. (Attach Plans)
13. Anticipated incremental development (i.e., phasing):
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:
15. If this is an industrial project, indicate the type of project, estimated employment per shift, and loading facilities:
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