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i e <br /> ` Environmental Information Form <br /> Part B <br /> DATE : I € -DUNE 9Q <br /> (To be Completed 3y Applicant ) <br /> NOTE : In completing this form, . use additional' sheets if necessary . <br /> Answer all questions to the best of your ability . If a question <br /> is not applicable to your project, write NA ( not applicable ) . <br /> Please do not leave blanks . incomplete forms cannot be accepted . <br /> PERSON COMPLETING FORM PROPERTY OWNER _AGENT OF OWNER <br /> Name WONT E:GJ&WEEPS IIJC-- <br /> Address S FE7&- ( L D�-• SUITF= h-' <br /> City STE) fJ <br /> State/Zip Cfl ISZD <br /> Prone 7 --p i <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application : Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, [y] Minor Subdivision, Q Site Approval , <br /> Q Zone variance, D Other : <br /> 2 . Project location: S. E . LAJE AJb ULL`( KOAD <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : LEC AUt `LE- blU(SW0 J <br /> DWIDiNJ i . C hC - ME PhZcE, 7 C- i <br /> CEL, F ? E i 2E M ENT- V SES . <br /> 3 . Total acreage of project: "3911 # of existing parcels : 'L- <br /> Assessor <br /> Assessor Parcel # (s ) :_ 5 - 3Z RND 3 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date:__ NONE. <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> N ONS <br /> Minor Subdivision - 7 - ( 5/85 ) <br />