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PROJECT INFORMATION <br /> Please provide project-related information for the following questions: <br /> 1, Do the proposed boundaries create an island of non-agency territory? [ ] Yes No <br /> 2. Do proposed boundaries split lines of assessment or ownership? [ ] Yes ] No <br /> 3, Does the proposal involve public rights-of-way or easements? [ ] Yes ] No <br /> 4. Does the proposal involve public land or land assessed by the State? [ ] Yes [x] No <br /> 5. Does any part of the proposal involve land under a Williamson Act [ ] Yes [x} No <br /> Contract or Farmland Security Zone? <br /> 6. Does any part of the proposal involve land with a Wildlife/Habitat [ ] Yes [X] No <br /> Easement or Agricultural Land Conservation Easement? <br /> 7. List the affected Assessor Parcel Numbers, Owners of Record and Parcel Sizes: <br /> APN Owner Acreage <br /> (Attach a separate sheet if necessary.) <br /> 8. Has an application been filed for an underlying project (such as Development Plan, <br /> Conditional Use Permit, or Tentative Subdivision Map)? [x] Yes [ ] No <br /> If Yes, please attach a Project Site Plan or Tentative Subdivision Map. <br /> If No, please provide an estimate of when development will occur: <br /> 9. List those public services or facilities which will be provided to the affected territory as a <br /> result of the proposed action: <br /> Water <br /> Lighting <br /> 10. Indicate which of these services or facilities will require main line extensions or facility up- <br /> grades in order to serve the affected territory-. <br /> Services are at the site <br /> 11. Provide any other justification that will assist the Commission in reviewing the merits of this <br /> request. (Attach a separate sheet if necessary.) <br /> Annexing to CSA 44 is a conditional of approval for MS-01-8 <br /> JLsvticatiori v'Proposai Revised. 04-21-03 Page 2 of 3 <br />