__________________________
(FOR LAFCO USE ONLY)
1 SAN BERNARDINO LAFCO
APPLICATION AND PRELIMINARY
ENVIRONMENTAL DESCRIPTION FORM
INTRODUCTION: The questions on this form and its supplements are designed to obtain enough data about the application to allow the San Bernardino LAFCO, its staff and others to adequately assess the proposal. By taking the time to fully respond to the questions on the forms, you can reduce the processing time for your proposal. You may also include any additional information which you believe is pertinent. Use additional sheets where necessary, or attach any relevant documents.
GENERAL INFORMATION
1. NAME OF PROPOSAL: Annexation to Barstow Fire Protection District of City-owned property (Wastewater Treatment Facility) __________________________________________________
2. NAME OF APPLICANT: _Barstow Fire Protection District____________________________ APPLICANT TYPE: Landowner Local Agency
Registered Voter Other________________________________
MAILING ADDRESS:
_220 E. Mountain View Ave. Barstow CA 92311________________________________________ ______________________________________________________________________________ PHONE: (_760_) _256-3531_____________
FAX: (_760_) _256-4472________
E-MAIL ADDRESS:
[email protected]________________________________________________
3. GENERAL LOCATION OF PROPOSAL
East Barstow adjacent to Interstate 40 and abutting the Marine Corps Logistics Base _________ _____________________________________________________________________________ ______________________________________________________________________________
4. Does the application possess 100% written consent of each landowner in the subject territory? YES NO If YES, provide written authorization for change.
5. Indicate the reason(s) that the proposed action has been requested. _______________________ To correctly include City’s 187-acre wastewater treatment facility in the BFPD service area. ______ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ __________________________
(FOR LAFCO USE ONLY)
2 LAND USE AND DEVELOPMENT POTENTIAL
1. Total land area of subject territory (defined in acres): ___Approximately 187 acres ________________________________________________________________
2. Current dwelling units within area classified by type (single-family residential, multi-family [duplex, four-plex, 10-unit], apartments)
____N/A________________________________________________________________________
3. Approximate current population within area:
____N/A_______________________________________________________________________
4. Indicate the General Plan designation(s) of the affected city (if any) and uses permitted by this designation(s):
_____Public Facility____________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ San Bernardino County General Plan designation(s) and uses permitted by this designation(s):
_____N/A_____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
5. Describe any special land use concerns expressed in the above plans. In addition, for a City Annexation or Reorganization, provide a discussion of the land use plan’s consistency with the regional transportation plan as adopted pursuant to Government Code Section 65080 for the subject territory:
___No change in use._____________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________
6. Indicate the existing use of the subject territory. ___Wastewater Treatment Facility_____________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ What is the proposed land use? __Continue as a wastewater treatment facility________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________
7. Will the proposal require public services from any agency or district which is currently operating at or near capacity (including sewer, water, police, fire, or schools)? YES NO If YES, please explain.
_______________________________________________________________________________ _______________________________________________________________________________ ______________________________________________________________________________ __________________________
(FOR LAFCO USE ONLY)
3 8. On the following list, indicate if any portion of the territory contains the following by placing a checkmark next to the item:
Agricultural Land Uses Agricultural Preserve Designation Williamson Act Contract Area where Special Permits are Required Any other unusual features of the area or permits required: _________________________ _______________________________________________________________________________
9. Provide a narrative response to the following factor of consideration as identified in §56668(p):
The extent to which the proposal will promote environmental justice. As used in this subdivision, "environmental justice" means the fair treatment of people of all races, cultures, and incomes with respect to the location of public facilities and the provision of public services:
The City of Barstow’s wastewater treatment facility will continue to provide fair treatment of people of all races, cultures, and incomes with respect to the location of public facilities and the provision of public service.____________________________________________________________________
ENVIRONMENTAL INFORMATION
1. Provide general description of topography. _
The general topography is flat with minimal elevation changes. Some of the northern portion of the property lies within the Mojave River._________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________
2. Describe any existing improvements on the subject territory as % of total area.
Residential ______________0_% Agricultural ______0_%
Commercial ______________ 0_% Vacant (142 acres)_____72_% Industrial (8 acres)_______ 4_% Other (ponds) (44 acres)____ 24_%
3. Describe the surrounding land uses:
NORTH __Mojave River_______________________________________________ EAST __Marine Corps Logistics Base__________________________________ SOUTH __Interstate 40________________________________________ WEST __Interstate 15_______________________________________________
4. Describe site alterations that will be produced by improvement projects associated with this proposed action (installation of water facilities, sewer facilities, grading, flow channelization, etc.). ______N/A______________________________________________________________________ __________________________
(FOR LAFCO USE ONLY)
4 _______________________________________________________________________________ ______________________________________________________________________________
5. Will service extensions accomplished by this proposal induce growth on this site? YES NO Adjacent sites? YES NO Unincorporated Incorporated
_______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________
6. Are there any existing out-of-agency service contracts/agreements within the area? YES NO If YES, please identify.
_______________________________________________________________________________ _______________________________________________________________________________
7. Is this proposal a part of a larger project or series of projects? YES NO If YES, please explain.
_______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________
NOTICES
Please provide the names and addresses of persons who are to be furnished mailed notice of the hearing(s) and receive copies of the agenda and staff report.
NAME ___________________________________ TELEPHONE NO. ________________________ ADDRESS:
____________________________________________________________________________________ NAME ___________________________________ TELEPHONE NO. ________________________ ADDRESS:
____________________________________________________________________________________ NAME ___________________________________ TELEPHONE NO. ________________________ ADDRESS:
____________________________________________________________________________________
CERTIFICATION
As a part of this application, the City/Town of _________________, or the ________________________ District/Agency, ____________________ (the applicant) and/or the _____________________ (real party in __________________________
(FOR LAFCO USE ONLY)
5 interest - landowner and/or registered voter of the application subject property) agree to defend, indemnify, hold harmless, promptly reimburse San Bernardino LAFCO for all reasonable expenses and attorney fees, and release San Bernardino LAFCO, its agents, officers, attorneys, and employees from any claim, action, proceeding brought against any of them, the purpose of which is to attack, set aside, void, or annul the approval of this application or adoption of the environmental document which accompanies it.
This indemnification obligation shall include, but not be limited to, damages, penalties, fines and other costs imposed upon or incurred by San Bernardino LAFCO should San Bernardino LAFCO be named as a party in any litigation or administrative proceeding in connection with this application.
As the person signing this application, I will be considered the proponent for the proposed action(s) and will receive all related notices and other communications. I understand that if this application is approved, the Commission will impose a condition requiring the applicant and/or the real party in interest to indemnify, hold harmless and reimburse the Commission for all legal actions that might be initiated as a result of that approval.
I hereby certify that the statements furnished above and in the attached supplements and exhibits present the data and information required for this initial evaluation to the best of my ability, and that the facts, statements, and information presented herein are true and correct to the best of my knowledge and belief.
DATE _______________________ _____________________________________________________
SIGNATURE
_____________________________________________________
Printed Name of Applicant or Real Property in Interest
(Landowner/Registered Voter of the Application Subject Property) _____________________________________________________
Title and Affiliation (if applicable)
PLEASE CHECK SUPPLEMENTAL FORMS ATTACHED:
ANNEXATION, DETACHMENT, REORGANIZATION SUPPLEMENT
SPHERE OF INFLUENCE CHANGE SUPPLEMENT
CITY INCORPORATION SUPPLEMENT
FORMATION OF A SPECIAL DISTRICT SUPPLEMENT
ACTIVATION OR DIVESTITURE OF FUNCTIONS AND/OR SERVICES FOR SPECIAL
DISTRICTS SUPPLEMENT
KRM-Rev. 8/19/2015