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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 h&-:Tg H t1iGY�Y <br /> Address o HNKs14VN <br /> city . "fnn suwt <br /> State/Zip TeYprs -7S22.5 <br /> Phone <br /> A. PROJECT DESCRIPTION - <br /> 1. Type of application: E] use Permit, Q Major Subdivision, <br /> [� Zone Reclassification, [l Minor Subdivision, 9 Site Approval, <br /> [J Zone variance, EJ Other: <br /> 2. Project location: 11191 VaLLaTo Court. F2emgF4 6k^P, CA <br /> Describe the project; i .e . , request being made and nature of use. <br /> Identify specific rp/roject' components : <br /> ��il r I aY7�.t C 07Trck V"�IQ�(EHtk�St <br /> Fi4 p1.1 �MP�,GMF..r' b.rtS WM-f�`DIJS� • MO GTpf✓ <br /> 3 . Total acreage of project: 4.Q0J # of existing parcels : <br /> Assessor Parcel # (s ) : (93 - 3b•07. <br /> 4 . If there is- an -existing EIR assessing any aspect of your project <br /> site, provide title and date: Nor L'It1of,)J <br /> 5 Other-permits and approvals (County, Regional,- State andFederal) - -- . <br /> - -- required--for-this project: <br /> PERMIT AGENCY ' <br /> ENC eoAc.1..n.e,,,T-. - - SY Cw,.�.., - {R' D4+• oaA4 S - - <br /> Site Approval Application - 5 - ( 6/86 ) <br />