Susanville, CA · Lassen County
Air Pollution Control District Permit Application
Businesses, agencies, and individuals use this application to request an air pollution control permit for equipment or processes in Lassen County.
What this form is
The Lassen County Air Pollution Control District application covers requests to install or modify emissions units, change permit conditions, and other listed permit actions. It asks for construction dates, ownership and facility details, the reason for applying, business activity, and device and emissions information. The form states that incomplete applications are not acceptable and may require supplemental forms, data, plans, or drawings.
Who needs it
A business, agency, individual owner, or project contact seeking a listed air pollution permit action for equipment or a process submits this application.
How to submit it
Submit the application to the Lassen County Air Pollution Control District at 66 N Lassen Street, Susanville, CA 96130. Include applicable fees and supplemental materials; the form lists a $56.75 application fee plus an evaluation fee.
About notarization
This document is signed and dated without a notary; the responsible party certifies the application information is true, accurate, and complete.
How to submit this form
- 1
Download The Application
Download the Lassen County Air Pollution Control District Permit Application PDF.
- 2
Complete The Form
Type or print in ink, provide the requested project, facility, and device information, and sign and date the certification.
- 3
Gather Supporting Materials
Include applicable fees and any required supplemental forms, data, plans, or drawings.
- 4
Submit To The District
Send the application to the Lassen County Air Pollution Control District at 66 N Lassen Street, Susanville, CA 96130.
Frequently asked questions
- Do I need a notary for the Air Pollution Control District Permit Application?
- No. The form requires the responsible party’s original signature and date, but it does not include a notary block.
- Who uses this permit application?
- Businesses, agencies, individual owners, and project contacts use it to request a listed air pollution permit action for equipment or a process.
- What information does the application ask for?
- It requests construction dates, organization and facility details, the reason for applying, business activity, responsible-party information, and device and emissions data.
- How do I submit the permit application?
- Submit it to the Lassen County Air Pollution Control District, 66 N Lassen Street, Susanville, CA 96130. Include applicable fees and supplemental materials.