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Street Address of Project Site

Assessor Parcel Number (APN) *

Your Name *

Your Company *

Email *

Your Project Role *

• Owner
• Architect
• Contractor
• Other

If other, please briefly describe your role

Best phone number to contact you

Email

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)
• NONE OF THE ABOVE (If NONE, skip following questions)

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

Approximately how many cubic yards of soil will be exported from the project site?

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

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