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.. Environmental Information Form <br /> Part B <br /> DATE : Sept 211 1989 _ <br /> (To be Completed By 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 X_AGENT OF OWNER <br /> Name nhelpstar-, !Re. <br /> Address 2800 N 44th St. , #AnA <br /> City 8-nos State/Zip AZ 85008 <br /> Phone <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Use Permit, Q Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, [�] Site Approval , <br /> Zone Variance, Q Other : <br /> 2 . Project location: <br /> Describe the project; i .e. , request being ma e an na ure of use . <br /> Identify specific project components : uecaiv® bu-1k Qule) , ;me <br /> from captive lime plant- and ErnrinrA a3cdrated 14me €er u.-;e in <br /> the No. Calif. and Nevada arca m,rk t� C-0. Ca(g8) 3, gase' ine, <br /> acetator, lubricator, etc _ <br /> 3 . Total acreage of project: # of existing parcels: 1 <br /> Assessor Parcel # (s ) :_ 17s_2q0_Q6 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: No <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> Site Approval Application - 5 - ( 6/86 ) <br />