Laserfiche WebLink
C <br /> Environmental Information Form <br /> Part B <br /> DATE: <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 AGENT OF OWNER <br /> Name Baumbach £ Piazza Inc <br /> Address_ 323 West Elm Street <br /> City Lodi <br /> State/Zip CA 95240 <br /> Phone_ (209) 368-6618 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application : 0 Use Permit, Q Major Subdivision, <br /> Zone, Reclassification, MX Minor Subdivision, Q Site Approval, <br /> Q Zone variance, Q Other: <br /> 2 . Project location: North side of Peltier, 1/2 mile Last of Bniella <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : a,mer is retiring and keening <br /> home_ <br /> 3 . Total acreage of project: 29 1/2 # of existing parcels: One <br /> Assessor Parcel # (s ) : 007-060-33 <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 /> Mone <br /> Minor Subdivision - 7 - ( 6/86 ) <br />