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Environmental Information Form <br /> Part B <br /> DATE : <br /> 4 o 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 W1 Lu <br /> Address <br /> City L(7D 1 . C A C <br /> State/Zip <br /> Phone '3) - 1. <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: CA Use Permit, Major Subdivision, <br /> Zone Reclassification, M Minor Subdivision, ;] Site Approval , <br /> Zone variance, Other: <br /> 2 . Project location:_ 1Q_74p -nn�kAy r_6L_onlY <br /> Describe the project; i .e . , request bein made and nature of use . <br /> Identify specific project components : 7� r�- �pMMF-PCJA <br /> 1-Io3Q�1 ST {cFJlrl�l_ F 1LrN i bd2 F <br /> }sem?I N C4. 11 '7D IStit C <br /> 3 . Total acreage of project: ± # of existing parcels : <br /> Assessor Parcel # (s ) :— h&3-220- M <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date : NONE- Kh�Oh.l4 <br /> 5 . Other permits and approvals (County, Regional, - State and Federal ) <br /> required for this project : <br /> PERMIT NI AGENCY <br /> Use Permit Application - 7 - ( 6/86 ) <br />