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C1 TY OF L4TH''FOP <br /> Ccn-nmunity Development Department App.> s? �, ?z <br /> Environmental Information Form Zm.g Lu <br /> _ Reeeiot <br /> 5-z- 9� <br /> E: <br /> OFFICE USE Oil': <br /> (To be Completed Ey .-._:icant) <br /> NOTE: In comOle tL= :'--4s form, use additicn" s:,e:_ : necessary. Answer all questions ; ...e <br /> best of you- a:iiity. If a question is net a_ciicable to your project, write N. "r.c: <br /> applicable;. _ _ease do not leave bia,<:. L—.cc._,olete forms s cannot be acceoted. <br /> PERSON COMPLETING FORM: Proper Owner V/ Agent of Owner <br /> Name 1'Z►C-I-e-- MC-CpjFy (A4-Eu-T FvR —To6cc> M^P-�-nJ4j) <br /> Address (050 1-}owe 1�,Vc, # 504 <br /> City SACF-X -t1e"To <br /> State/Zip CA 1)5826- <br /> Phone <br /> 5826Phone (910 &46-4M3 Fex (910) (04(0-4(0-19 <br /> A. PROTECT DESCRII=ON <br /> I. Type of Application: Use Permit ❑ Tentative Map ❑ Zone Reclassification ❑ <br /> Parcel Map ❑ Site Plan Review N Variance ❑ General Plan Amendment ❑ <br /> Other ❑ (Please <br /> 2. Project location: 16470 L'AMBP-iDCgc DR.%VE <br /> Descnbe the projecn i.e., request being made and nature of use. Identify specific prciect <br /> components: <br /> Up(�Ra.Dl�l of exls-rIACJ -fucu0(1 STS-TBM) "Ew c.kuoP'f , <br /> Rr,-pL-&u10y t,xts r,�i C� 61619AyE ) 00w <br /> 3. Total acreage of pro::e c Ao = cf axis ing parcels: <br /> Assessor Parcel Ne.'sl 1% <br /> 4. If there is an exisd,_ EL2 assessing any aspect of vcur project site,WndAlela and dare: <br /> JUN 13 1997 <br /> Ans'd............ <br />