LOCAL GOVERNMENT TRIBAL CONSULTATION LIST REQUEST
NATIVE AMERICAN HERITAGE COMMISSION
915 CAPITOL MALL, ROOM 364
SACRAMENTO, CA 95814
(916) 653-4082
(916) 657-5390 - Fax
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Project Title: _________________________________________________________________________
Local Government/Lead Agency: ________________________________________________________
Contact Person: ______________________________________________________________________
Street Address: _______________________________________________________________________
City: ____________________________________________Zip:________________________________
Phone: __________________________________________Fax: _______________________________
Specific Area Subject to Proposed Action
County: _______________________________________________________________________
City/Community: _______________________________________________________________
Local Action Type:
___ General Plan ___ General Plan Element ___ General Plan Amendment
___ Specific Plan ___ Specific Plan Amendment
___ Pre-planning Outreach Activity
Project Description:
_____ Sacred Lands File Search and Native American Contacts List Request
Information Below is Required for a Sacred Lands File Search
USGS Quadrangle Name___________________________________________________
Township _____ Range _______ Section(s) _________
NAHC Use Only -
- Date Received: _______________
- Date Completed _______________
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- Native American Tribal Consultation lists are only applicable
for consulting with California Native American tribes per Government
Code Section 65352.3.
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