Location of Project:

Street Address:

Assessor's Parcel Number (APN):

Contact Info:

Your Name:

Project Role:
Owner Architect Contractor

Company:

Mailing Address:

City, State, Zip:

Phones:

Office:	Ext:
Cell:
Fax:
Other:	Type:

email:

1)

Does the project involve soil borings, trenching, site grading, cutting through an existing floor slab or other soil excavation? Yes No
If No, stop here and submit this form (below). If Yes, complete questions 2-5 and submit.

2)

What is the approximate volume of soil to be moved? cubic yards.

3)

What is the approximate maximum depth of the planned soil excavation below the existing grade? feet below ground surface.

4)

Is the soil to be exported from the project site? Yes No
If yes, what is the approximate volume of soil to be exported? cubic yards.

5)

Check all of the following excavation or other types of activities that are part of the project:
Site grading to construct a building pad or other reconfiguration of site topography.
Soil geotechnical borings or other drilling
Excavation for building foundations
Trenching for underground utilities
Cutting through an existing floor slab in an existing structure on the parcel
Demolition of existing structure(s)

6)

Will the project result in use of the property for any of the following?
Residential use
Hospital for humans
School for persons under 21 years of age
Daycare center for children
NONE OF THE ABOVE