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UP 76-20 - Use Permit - Daycare - 1977CITY OF CAMPBELL 995 APPICOT AVE. UP 76-20 1 of 2 I L9e9�5 Aprin:icot A—ae UP 76-20 1. B. FOR M:CROF!I,'AtN6 r ero.,:.:a er • 13 w lr_LO—%3 �1%+•_ k. r J RESOLUTION HO. 1574 PLANNING COMMISSION CITY OF CAMPBELL, CAL11-ORNIA After notification and public hearing as specified by law on the application of Linda Carol Lewin and Linda Beth Allen for approval of a use permit and approval of plans to allow a day-care center in existing structures located on property known as 995 Apricot Avenue in a C-2-S (General Commercial) Zoning District, as per application filed in the office of the Planning Department on November 22, 1976' and after pre- sentation by the Planning Director, proponents, and opponents, the hearing was closed. After due consideration of all the f.widence presented; the Planning Commission did find as follows: 1. llat the establishment, maintenance and operation of the proposed use will not be detrimental to the health, safety, peace, morals, comfort or general welfare of persons residing or working in the neighborhood of such use, or be detrimental or injurious to property and improvements in the neighborhood, or to the general welfare of the City. Bated on the above findings, the Cur -mission does hereby grant the requested use permit subject to the following conditions: 1. The use permit shall expire one year from the date of approval of the use permit if the use has not started. 2. Buildirysconver•ted from single family residential to day-care centers shall be required to conform to a Group C Type V-N, Chapter B. 1973 Uniform Building Code. 3. Applicants to provide a "2A-I0BC" fire extinguisher. 4. Applicants to provide a manual fire alarm system. 5. Applicants to submit a floor plan of the facility to the Fire Department. USE PERMIT TO BECOME VALID ON J,ANUARY 28, 1977. PASSFD AND ADOPTED THIS 18th day of January, 1977, by the following roll call vote: AYES: Commissioners: Hebord, Campos, Vierhus, Pack, Samuelson, Lubeckis, Dickson NOI.S: Comnissioners: None ABSENI: Commissioners: None APPROVED: J. DuWavne Dickson ATTCST: Arthur A. Kee --"2liaiimari - �Sec i•et:ai ;J UP 76-20 This is the time and palce for continued public hearing,. Lewin, Linda C. to consider the application of lima Carol Lewin and Linda Beth Alien for approval of a use permit and approval of plans to allow a day-care center in existing structures located on property known as 995 Apricot Avenue in a C-2-S Ilea (General Commercial) Zoning District. I Chairman Dickson asked for the repert of the Architectural Review Committee. Commissioner Pack reported that the committee met with the applicant and recommends approval of the application subject to the conditions re^ommended by staff. Mr. Kee presented the plans for the Commission's review. "tip hearing was continued j to this meeting so the applicant could submit more detailed plans and after dis- cussion at the Architectural Review Committee meeting, the staff recommends approval. Chairman Dickson announced this is a continued public hearing and asked if anyone wished to speak for or against the: eppl;cation. Mr. Michael Lannen, part owner and manage- of Mr. Steak Restaurant, stated that this development is adjacent to his restaurant and during the time of day that the applic- cants would require more parking his parking lot is not being used. Therefore, he has offered the use of his parking lot to the applicants as it is a large lot and two-thirds of it is seldom used. Commissioner Hebard moved that the public hearing be closed, seconded by Commissioner Vierhus and unanimously adopted. RESOLUTION NO. 1574 Commissioner Vierhus moved that the. Commission adopt Resolution No. 1574 approving the application of Linda Carol Lewin and Linda Beth Allen for a use permit and approval of plans to allow a day-care center in exiting structures located on property known as 995 Apricot Avenue in a C-2-S zone subject. to the conditions recommended by staff, seconded by Commissioner Pack and adopted by the following roll call vote: AYES: Commissioners: Hehard, Campos, Vierhus, Pack, Samuelson, Lub^cki'., Chairnnn Dickson NOES: Coivnissioners: None ABSENT: Commissioners: None -J, Item k3 STAFF COMMENT SHEET - PLANNING COMMISSION MEETING OF JANUARY 18, 1977 UP 76-20 Continued public hearing to consider the application Lewin, Linda C. of Linda Carol Lewin and Linda Beth Allen for Allen, Linda B. approval of a use permit and approval of plans to allow a day-care center in existing structures located on property known as 995 Apricot Avenue in a C-2-S (General Commercial) Zoning District. STAFF RECOMMENDATION: Approval, subject to the following conditions: 1. The use permit shall expire one year from the date of approval of the use permit if the use has not started. 2. Building converted from single family residential to day-care centers shall be required to conform to a Group C Type V-N, Chapter 8, 1973 Uniform Building Code. 3. Applicants to provide a "2A-I0BC" fire extinguisher. 4. Applicants to provide a manual fire alarm system. 5. Applicants to submit a floor plan of the facility to the fire department. STAFF DISCUSSION: The applicants are proposing to convert an existing residential building into I a pre-school facility. The total floor area of the main residential building is indicated as approximately 1,500 square feet. The total lot size is approximately 10,800 square feet. The property to the north and south, along Bascom Avenue, is used predominately for commercial purposes. There is a non -conforming re idential building immediately to the north of the subject property. The property along Apricot Avenue is predominately residential, although the one lot adjacent to the subject property is the site of the Water Babies Swim School. Staff is of the opinion that the site is suitable for use as a pre-s'.hool and previous concerns have now been resolved with the submission of a detailed site plan. UP 76-20 This is the time and place for continued Lewin, Linda C. to consider the application of Linda CaroluLewin blic hand ring Allen, Linda B. Linda Beth Allen for approval of a use permit to allow a day care center in existing structures located on Property known as 995 Apricot Avenue in a C-2-S (General Commercial) Zoning District. Chairman Dickson reported that the Architectural Review Committee met with the applicant and recommends continuance to the next regular meeting. The applicant 4 is in the process of preparing plans to submit to the Commission at the next meeting. Commissioner Samuelson stated that the property owner is in agreement with the continuance and they will have more information and plans at the next meeting. Commissioner Pack move:+'chat UP 76-20 be continued to the January 18 meeting, seconded by Commissioner Vierhus and unanimously adopted. e J Item N7 STAFF COMMENT SHEET - PLANNING COMMISSION MEETING OF JANUARY 4, 1977. :5 UP 76-20 Continued public hearing to consider the application of Lewin, Linda C. Linda Carol Lewin and Linda Beth Allen for approval of Allen, Linda B. a use pe mit to allow a &y care center in existing structures located on property known as 995 Apricot Avenue in a C-2-S (General Commercial) Zoning District. STAFF DISCUSSION This item was continued from the last regular meeting of the Planning Commission in order that the applicant could submit a detailed site plan. As of this writing, the site plan has not been received by this department so revised comments cannot be made. A copy of the previous comment sheet is attached for the Commission's review. UP 76-20 Public hearing to consider the application of Linda C. Lewin Lewin, Linda C. and Linda B. Allen for approval of a use permit to .allbk,a Allen, Linda B. pre-school facility in existing structures located on property known as 995 Apricot Avenue in a C-2-S (General Commercial) Zoning District. Mr. Kee reported that the existing facility was used for a day care center previoi.sly, but has not secured a use permit from the City of Campbell as it was not annexed to the City at the tine. Mr. Kee further stated that the staff is recommending approval subject to conditions stated on staff comment sheet. Vice Chairman Dickson declared the public hearing open and asked if anyone wished to speak for or against the application. Mr. Patrick P. 0. Box 477, Clear Lake, owner of the Property, stated that one of the main problems is that his building was remodeled at an expense of over $8,OC'0 to meet the specificaticns for a nursery school. It has been approved by the State of California for 30 children. The school had to be closed in 1972 due to Mr. Patrick's illness. Mr. Patrick noted that he felt there were several errors in calculation on the staff write-up and noted each one to the Commission. Mr. Lyne Davis, 1004 Hazelwood, San. Jose, spoke in favor of the use permit stating that he felt parking would be no problem as there would be only two or three cars at a time on the property for staff. Mr. Kee stated that he was concerned, at this point, about the site layout. He did not know how the traffic was going to work at this time. Mrs. Patrick , P.O. Box 477, Clear Lake, wife of the owner and Director of the prc— school came forward and addressed the Commission. Mrs. Patrick stated chat the school had been meeting State requirements (which she felt were morestrict than Campbell's requirements) since 1970. All nursery schools are policed by health officials and other State officials more than any other government facility. Miss Lynn Lewin, 1596 Davis St., San Jose, applicant, came forward and stated that there would be three staff people taking care of 30 children. Miss Lewin stated that she has another school in San Jose with a waiting list of 25 children. She would be glad to send brochures to the Commission describing her other establishment. The application before the Commission would be a sister school to her other school. Miss Lewin stated her school has a good reputation in San Jose, she takes a special interest in her children and would build the same reputation in this pre-school. Commissioner Samuelson moved the public hearing be closed, seconded by Commissioner Vierhus and rnanin-ausly adopted. Commissioner Pack moved that this item be continued to the first meeting in January so that the applicant can submit a site plan to be reviewed by the Site and Architectural Conmittee and the Planning Director re -review his recommendations, seconded by Commissioner Samuelson and unanimously adopted. Item a6 i STAFF COMMENT SHEET - PLANNING COMMISSION MEETING OF DECEMBER 16, 1976 UP 76-20 Public hearing to consider the application of Linda C. Lewin, Linda C. Lewin and Linda B. A1'.en for approval of a use permit to Alle.:, Linda B. allow a pre-school facility in existing structures located on property known as 995 Apricot Avenue in a C-2-S (General Commercial) Zoning District. (See map and applicants' statement attached). STAFF RECOMMENDATION: Approval, subject to the attached conditions. STAFF DISCUSSION: The applicants are proposing to convert an existing residential building into a pre-school facility. The total floor area of the main residential building is indicated as approximately 1,300 square feet. The total lot size is approximately 10,500 square feet. In the applicants' statement, reference is made to the fact that the site was used for a day-care facility during the period 1960-1971. No use permit was ever granted for this operation by the City of Campbell, however, as the property was not annexed to the City until May 27, 1970. The property to the north and south, along Bascom Avenue, is used predominately for commercial purposes. There is a nonconforming residential building immediately to the north of the subject property. the property along Apricot Avenue is predominately residential, although the one lot adjacent to the subject property is the site of the Water Babies Swim School. There is a two-story accessory building on the site which is apparently being used for residential purposes. A number on the buildinc identifies the building as 983 Apricot Avenue. Staff is of the opinion that the site is suitable for use as a pre-school, however, the staff also has several concern; about the details of thz pre-school operation on this site. One of the staff concerns involves the on -site parking. Approximately 3,500 square feet of the lot is currently being used for parking in conjunction with the Water Babies Swim School. The applicant has indicated that there is a "common parking easement" with the swim school. One of the reasons staff is recommending that the project be considered under site and architectural approval is so that the details of the of -site circulation can be resolved. Staff is also concerned about the area which is currently available as an outdoor play arna. The play area, which is primarily located in front of the main dwelling, adjacent to Bascom Avenue, appears to the staff to be small in relation to the overall size of the site. -,�....:.: x ,._ �: .,..,.e.'�vr-•.,.."MrIF..Vu ti0/11�►.rfsa.*' y�� UP 75-20 Lewin, Linda C. Allen, 1. nda B. Page Two Lastly, staff is concerned about the overall intensity of the land use which would result if the project were to be approved as presented. If one does not consider the existing parking area, since it is used jointly with the swim school, only 7,000 square feet of lot area remains for the pre-school facility. Of this 7,000 square feet, approximately 3,000 square feet is used in connection with the accessory building and its residential use. This leaves only 4,000 square feet (approximately) which can be devoted solely for use by the pre-school. In staff's opinion, the intensity of use for this property is extremely high. For this reason, staff is recommending that the existing accessory building be removed in order to provide additional area for on -site circulation, parking, landscaping, and play areas. CONDITIONS OF APPROVAL - UP 76-20 Lewin, Linda C. Allen. Linda B. 1. Applicants to obtain "Site and Architectural Approval." 2. Applicant to remove existing accessory building. 3. The use permit shall expire one year from the date of approval of the use permit if construction has not started. 4. Building converted from single family-esidential to day-care centers shall be required to conform to a Group C Type V-N, Chapter 8, 1973 Uniform Building Code. 5. Applicants To provide a "2A-IOBC" fire extinguisher. 6. Applicants co provide a manual fire alarm system. 7. Applicants to subnit a floor plan of the facility. y,. t i� t� 01 i I ti � L N' II�II r I W U I 1. Justification: The proposed site has been a pre-schor' between the years 1960-1971. Presently the property is set up for a nursery school. It i:, fully fenced, there is a direct fire alarm system installed, existing are 3 restroom facilities for the children, the playground is tan -barked and there is a sandbox. We intend to have a staff of 3 and parking is no problem since there exists a common parking easement with Water Babies Swim School directly behind this site. This facility will be of a very high standard. We now operate a pre-school facility on 1131 Park Avenue in San Jose that is attractive. and operating very successfully. We are fully licensed with the state and have been in this business for almost 5 years. There will be no structural alterations to the building. The exterior of the building will be attractively painted and the land- scaping will be neat and tidy. We will also abide with Campbell's sign control ordinances. We sincerely feel our facility will benefit the city of Campbell. 0 CITY OF CAMPBELL 75 NURTH CENTRAL AVENUE CAMPBELL, CA L I F 0 R N I A 95008 (408) 378-8141 Department: Fire March 30, 1977 Ms. Lynne Lewin Bascom Pre -School 995 Apricot .Avenue Campbello CA 95008 CERTIFIED MAIL Dear Ms. Lewin: On February 18, 1977, a notice with an application was sent to you stating that the Bascom Pre -School would require a Fire Department Permit to Operate a Day Care Nursery. There was no response to that notice. On March 170 1977, a second notice was sent to you with another application. On March 28, 1977. I met with you at the Pre -School where you stated that you had returned the completed applicatinn along with the $25 Permit Fee. This letter is to notify you that the Campbell Fire Department has not received any such application nor a fee. I have also ascertained that a Business License has not been obtained for the above mentioned Pre -School. I contacted Ms. Joan Phillips of the Day Care Licensing Division of the State Department of Health and she has no knowledge of an application for a license from the State of California for the Bascom Pre -School. There has been no fire clearance issued for the Bascom Pre - School and the Pre -School is operating in violation of Section 17.08 of the Campbell Municipal Code. This item is being referred to the City .Attorney of Campbell for disposition. .rJ M 110) CITY OF CAMPBELL Ms. Lewin Bascom Pre -School If you have any questions or if we can assist you in any way, please give us a call. Sincerely, E. W. Borden, Fire Chief Campbejl Fire -Department S. A. LeonKrdi, Baton Chief Fire Prevention Bureau EWB:SAL:mm cc: J. Robert Dempster City Attorney Dorothy Trevethan City Clerk Art Kee Planning Director kESOLUTION NO. 1574 PLANNING COMMISSION CITY OF CAMPBELL, CALIFORNIA After notification and public hearing as specified by law on the application of Lina Carol Lewin and Linda Beth Allen for approval of a use permit and approval of plans to allow a day-care center in existing structures located on property known as 995 Apricot Avenue in a C-2-S (General Commercial) Zoning District, as per application filed in the office of the Planning Department on November 22, 1976, and after pre- sentation by the Planning Director, proponents, and opponents, the hearing was closed. After due consideration of all the evidence presented, the Planning Commission did find as follows: 1. That the establishment, maintenance and operation of the proposed use will not be detrimental to the health, safety, peace, morals, comfort or general welfare of persons residing or working in the neighborhood of such use, or be detrimental or injurious to property and improvements in the neighborhood, or to the general welfare of the City. Based on the above findings, the Commission does hereby grant the requested use permit subject to the following conditions: 1. The use permit shall expire one year from the date of approval of the use permit if the use has not started. 2. Buildirgsconverted from single family residential to day-care centers shall be required to conform to a Group C Type V-N, Chapter 8, 1973 Uniform Building Code. 3. Applicants to provide a "2A-108C" fire extinguisher. 4. Applicants to provide a manual fire alarm system. 5. Applicants to submit a floor plan of the facility to the Fire Department. USE PERMIT TO BECOME VALID ON JANUARY 28, 1977. PASSED AND ADOPTED THIS 18th day of January, 1977, by the following roll call vote: AYES: Commissioners: Hebard, Campos, Vierhus, Pack, Samuelson, Lubeckis, Dickson NOES: Commissioners: None ABSENT: Commissioners: None APPROVED:J. D�uWayii Dickson � ATTEST: Arthur A. Kee Chairman Secretary d. u34 . is 16k.. t "IIIIU OF I'll F FAR(JLOVS SANTA CLARAVAU.M'r 75 NO M CI.NUAL AVIIJUf •'CAMPULL• CAI IfORMA 95000 . 11LEPH6IJI. (400) 378-6141 a.l EIR - 2 File 1 UP '6-20 _ DEC1.1 1RATION •I11AT AN L'NVIRONVIENTAL IiIPACT IMPORT IS NOT REQUIRED (ENDORSED) (NIiGA•I'1VG UECLAI:A7'ION) I E F APPLICANT : Linda Carol Lewin/ Linda Beth Allen CSC -1 1976 ADDRESS 1131 Park Avenue JOHN KAZUBOWSKI, Clerk San Jose _- Deputy PROJECT NAM: day care center ADDRESS 995 A ricot Ave. Gn,ipEe1T(:a 1 i ('ornia Pursuant to the applical,lc sections of the California Environmental Quality Act of J970 and City of Campbell Resolution No. 3766 ; and After review of plans and information supplied by the applicant per- t.ainin„ to the Captioned proicCt, the undersigncc( does hereby determine that the captioned project will have no significant effect (no substantial adverse impact) on the environment within the terms and meauing of said Act and Resolution. The reasons for making this declaration arc as follows: There are no reported endangered species of plants or animals on the site. The surrounding area is nearly completely developed, This project will not release any harmful elements into the atmosphere. Executed at Campbell, California, this 30th day of November -, 1976-, ARTIUM A. KIT Director or -- --I Official BY STAFF CALCULATION SHEET DATE: _ AGENDA DATE: NAnE: _:A/j,-„/ ADDRESS: FILE/ Ujff)(.-Za APN:_ ZONEt PROPOSED USE: a—.. � LOT AREA: 10 B 17, �L BUILDINC AREA BY USE: BUILDING AREA: �� y� .y 1, 7�0•1 COVERAGE: 3. „i775 O' PARKING PROVIDED: �� CODE: PARKING RATIO PROVIDED: /. 3 �.q COD6t tier- `7- �- - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ LANDSCAPING: PROVI DLD_!- j__y�7_ CODE: (Percent) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - SETBACKS: AS PROVIDED CODE FRONT LEFT SIDE RIG:'T SIDE REAR DENSITY (RESIDENTIAL) IIUNEER OF UNITS: UNITS PER ACRE PROVIDED CODE OPEN SPACE PROVIDED CODE ZONES BORDERING PARCEL FRONT �S_.- REAR__ �•l LEFT SIUE_C'- ?- : i _ RIGI,T SIIIE_ ! 1 PROOF OF PUBLICATION STAVE OF ( ALIFOKNIA. -tun(v of Santa (Tara I am a cilixen of the Uniled States and a resident of the county aforesaid: 1 am over the age of • tghleen yeah, and not a party tit at, inlermted in the above -entitled matter. I am the principal r hark of the printer of till Iliilon Avenne, l'ampt"11. ( alif(aroia, a news- !.;:lles, of general circulation, printed and pub- I.Ard every Wednesday in lhl- city of ('ampM•il. ( ounly of Santa )Taro: and whic•I: newsplper hits been adjudged a newspaper of Getu•ral eh•eoln- I,cut 1,N lh(• Superior ('oust of the ('omdy of Santa !ara, State of California. t'ase Nunther Sd018: bat till notice of which the annewil is a priuled ..nv (sat in type not smaller than non-pareil). I'as hero publlshed in r:.ch regular and entire i. ue of said newspaper and not ;Ti an.i supplr- �­w (heirof nn the lollowin){ dales, to wii: December 2 oil in Ih.• year 1976 y� i .ertify Iur declare) under plain)% of perjury Celt till- foregoing Is true and ctavn•cl. Dated at Campbell. Califoruin, this 9nd �f ]k ce mbar 76� 7 Signature 0 IThi+ space is for the C(taaty Clerk'% Filing Stamp in.4 '157_-D I'ItOOF OF PUBLICATION OF `I, lip :i' Iy�Y a�itbr M- lYto art . ttfohow4o? o►f•emY b tletYt � . ate' A.Rt/t� tour awl >tia�.! �,7O"W60060 0A hlattoaYYl� . Cdlo* todptor told as hwd at r�1 l7� Af"A qe=2MM ^' UP USE PERMIT CITY OF CAMPBELL, CALIFORNIA APPLICANT NAME: IL 1dA .Cr!„'i/' �i.CinrYa, 1��1fi '�r/!C'>t DATE:ljy % (Please type or print ADDRESS: //3 / Arx /VV C .Y- C "L TELEPHONE: Z 97a> 2U PROPERTY AUURCSS�/S �iLOI/� U A✓� Ly.6P��� Ga„ # y/3=yy-/oo Applicant RUST attach legal description of property IMPROVEME14TS: Existing /3G0 26d 26.iivmc.' Proposed (JS.e- (nr USE APPLIED FOR: (Applicant MUST citesectiDn number of Campbell Municipal Code which authorizes Planning Commission to grant the particular,use applied for; _a/. !__'1. ri 70 1,'6 APPLICATION: I/We, the undersigned person(s) havini- an interest in the above described property, hereby make application for a Use Permit of the nature set forth above, in accordance with the provisions of the Campbell Municipal Code of the City of Campbell, California, and I/We hereby certifv that the infornation given herein is true and correct to the best of my/oar I:uowledge and belief. y2� jIjI ypp`�V��JJJJ,L'Jj�I��� Re 7ectful y suhmitte .- Rd akIf n�rni �m�,I`1_ ' Signa ire It VITV OF --roTZ--eC�Srp- (f.ddress (\�_ PL ANNING oEP-RTMENT ease print applicantrs name �i�. Date) 19'7 c INFORMATION FOR PERSONS MAKING APPLICATION FOR A USE PE,'6lIT Use Permit application should be completely filled out and filed in the office of the Planning Department, 7S North Central Avenue, Campbell, California, on forms obtained from said office. The Campbell Planning Commission meets on the first and third Thursday of each month at the City Hall. A public hearing is required on each application. The Planning Commission Secretary is required to give public notice of said hearing not less than ten days prior to the date of the meeting at which the hearing is held. In addition to the application form properly completed, additional information should be furnished by applicants covering the follow- ing points: i 1. Justification: A clear and detailed statement in writing su— stantiaLing the request for a Use Permit. 2. Map or showing the boundaries of the area for w ih'cha Usc Permit is requested and of the property surrounding the same for a distance of five hundred feet. 3. Other data, such as letters,petitions, drawings or p oii tograp�is which the applicant wisi:es to relate to his application. 4. A fee of $50.00. Make check payable to the City of Campbell. Attention of applicants is especially called to the importance of being present at public hcarintis. The burden of presenting the matter to the Planning Commission and to the City Council is on the applicant, and failure to he present at a hearing may adversely affect the applicant's chances of obtaining, the Use Permit he requests. ;m FORM EIR-1 CRITERIA ro^ PROJECTS NNICh MAY.& •- A SIGNII'ICAN7 ENVIRO::MEN7A :XPACT Answer the following questions by piacine a check in the appropriate space. Yes 1:o 1. Could the project significantly chan;,e present uses of the project area? 2. Could the project significantly char.pc present / uses of laud outside the project area? V 3. Could the project affect the use of a recre- ational area or area of important aesthetic value? —� 4. Could the project substantially affect the functioning of .an eutablished community? .5. Could the project result in the displacement of / community residents? G. Are any of the natural or man -Cade features in the project area unique, that is, rot found in other parts of the county? 7. Could the project significant ).y affectt a knovrn - historical or a:•chr.elogical site or its settin,,^.? V B. Could the project signficnntly affect the po- tentia). use, extraction, or conservation of a natural resource? 9. hoes the project area serve as a he1•.itat, food source, nestini; place, source of waier, etc. for , / rare or endrngcred wildlife or fish species? r- 10. Could the project signSficantly affect fish, ./ wildlife, or plant life? - _-V_ 11. Are there ar.y rare or endangereq plant species / in the project area? --v 12. Could the, project result Sn the ero::Son of outside property? . -10- J aM Yes 13. Will the project require a variance froro esta9- lislied envirom:,ental standards (air, hater, `-- --- noise, etc), and/or adopted plans? ' 14. Will the project require certification, author- izatiou or issuance of a permit by any lncal, state, or federal environmental control agency? ' If so, please indicate name of the agency ,/ 15. Will the project involve the application, use or disposal of hazardous materials? � V_ 16. Will the project involve construction of facilities in a flood plain? 17. Will the project involve construction of facilities in the area of a known active fault? ln. Could the completed projrct result in the generation of significant amounts of noire? — — 19. Could the construction of the project result in the generation of significant amounts of dust? ` ✓ 20. Could the completed projrct result in the generation of ::f.gnificant amounts of dust? 21. Could 'the project result in a sirnificant'change in the quality of any Portion of the region's air or water re::ources? (Should note surface, ground water, offshore.) -11- 1L � Stalcu�cut of tlo ,i���icunt I:nvirou;aentaj I:ff�_• If you have answered yes to one or note of the questions in Section lI, but still think that the project will t.ave no Secnificaut env effects, indicate your reasons below. Ad/ddr/=e,s�s,�of project Da c &cu w it d �;nda,et� AJlt �- ea 'nts _n am /- p K i Ileaits Signat . I � I r L_ J CITY OF CAMPBELL 995 APRICOT AVE. UP 76-20 2 of 2