Project Intake Form (PowerApp)

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THCP: Project Intake Form (PowerApp)

Step 1: Project Intake Form This form provides the necessary data to determine which Tribal sensitivity category the Project falls in. A response will be provided within 5-7 business days with the sensitivity level and a link to the final form, the Project Consultation Form.

"*" indicates required fields

Step 1 of 7

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This form provides the necessary data to determine which Tribal sensitivity category the Project falls in. A response will be provided within 5-7 business days with the sensitivity level and a link to the final form, the Project Consultation Form.

Submission Date:

Project ID:

This is your Project ID, please remember it.

Name*

First Last

1A. APPLICANT (IF YOU REPRESENT A CRM FIRM, PLEASE COMPLETE THE "TRIBAL INPUT FORM")

Company Name

Project Owner or Project Manager Name:*

Address

Street Address Address Line 2 City State ZIP Code

Telephone

Email*

1B. LEAD AGENCY (Lead Overseeing Entity)

Lead Agency*

E.g. "City of Santa Clarita" or "County of Los Angeles, etc.

Point of Contact*

First Last

Email*

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Email*

2. SUBJECT PROPERTY (Project Site)

Project Name*

Assessor's Parcel Number(s)

It should be that one of the following three field is required: Assessor's Parcel Number(s), Township and Range, Address

Township and Range

Address

Street Address Address Line 2 City State ZIP Code

Project Size

Approx. Acres

Project Type*

Industrial

Commercial

Residential

Recreational

Other

Please check off which applies to the Project type.

Regulatory Framework*

AB 52

Section 106

AB 168 (SB 35)

AB 130

Other

Please check off which applies to the Regulatory Framework.

If 'Other,' explain the Project Type.*

If 'Other,' explain the Regulatory Framework.*

3. DOCUMENTATION

Initial Study*

Available

In Preparation

Not Required by Lead Agency

Not Available

Please check off which applies to the Initial Study.

Environmental Impact Report*

Available

In Preparation

Not Required by Lead Agency

Not Available

Please check off which applies to the Environmental Impact Report.

Sacred Lands File*

Available

In Preparation

Not Required by Lead Agency

Not Available

Please check off which applies to the Sacred Lands File.

Cultural Resources Assessment*

Available

In Preparation

Not Required by Lead Agency

Not Available

Please check off which applies to the Cultural Resources Assessment.

Archaeological Report*

Available

In Preparation

Not Required by Lead Agency

Not Available

Please check off which applies to the Archaeological Report.

Geotechnical Report*

Available

In Preparation

Not Required by Lead Agency

Not Available

Please check off which applies to the Geotechnical Report.

Biological Report*

Available

In Preparation

Not Required by Lead Agency

Not Available

Please check off which applies to the Biological Report.

Construction/Grading Plans*

Available

In Preparation

Not Required by Lead Agency

Not Available

Please check off which applies to the Construction/Grading Plans

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Submitting all documentation marked as "Available" to the Cultural Resources Management (CRM) Division of the Fernandeño Tataviam Band of Mission Indians (FTBMI) will assist in the proper determination of the sensitivity level and associated requirements for the subject property. All documentation submitted to the CRM Division of the FTBMI will be treated as confidential and only used for the evaluation of the subject property and internal training practices when necessary.

4. PREVIOUS ACTIVITIES

Has the site been previously developed?*

Yes

Unknown

Does the site currently contain fill?*

Yes

Unknown

What portion of the property has NOT been previously impacted and/or contains Native soil?*

20% or less

50% or less

80% or less

100% or less

Unknown

Are there any oak trees on the subject property or within 100 feet of the property?*

Yes

5. OAK TREE ENCROACHMENT

Removal

Please identify the number of oak trees proposed for:

Encroachment

Please identify the number of oak trees proposed for:

To Remain

Please identify the number of oak trees proposed for:

Total

Total Existing Oak Trees

Are there any oak trees on or next to the subject property that date to or prior to 1934?

Yes

Estimated oak tree dimensions (average):

Select one of the following:

No activity will occur within five feet of any oak tree dripline (canopy) or within 15 feet of any oak tree trunk, whichever distance is greater. This applies to both oak trees located on the subject property AND oak trees next to the subject property.

Activity will occur within five feet of any oak tree canopy or within 15 feet of any oak tree trunk. All oak tree dimensions, including trunk diameter and canopy, are accurately depicted on the site plan and are drawn to scale.

6. NATIVE PLANT ENCROACHMENT

Are there any native plants on or next to the subject property that will be impacted by this project?*

Yes

Unknown

If you selected yes for the question above, please list plant species impacted and describe the impact (i.e. removal)

Please provide any additional pertinent information that may be significant for the review process

7. APPLICANT CONSENT

Consent

I have read, understand, and consent to the submission of this form. I understand the Cultural Resources Management (CRM) Division of the Fernandeño Tataviam Band of Mission Indians (FTBMI) will review the contents of this form and any applicable documentation made available by the applicant to determine the sensitivity level of the subject property and whether consultation is required. I understand that if consultation is required, a consultation application will be issued to me which will begin the CEQA consultation process. If an agent/consultant signs for the applicant, please submit a letter of authorization from the applicant with original signature(s):

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I have carefully reviewed all items under Sections 3 through 6 and included all applicable required information

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The information provided in this application, including all attachments, are accurate and correct

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I understand that the submittal of inaccurate or incomplete information and plans may result in extension of the subsequent consultation period.

Application Processing Fee

Intake Processing Fee

Price:

Total

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