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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 /> NameIJUmCOG/7 d !� /CIZZCc <br /> Address 3 23 E/.,, JS . <br /> City Lod, <br /> State/Zip G"../' /. -iS24a <br /> Phone 3G%:!? -e G <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, � Major Subdivision, <br /> Zone Reclassification, D Minor Subdivision, Q Site Approval, <br /> Q Zone variance, Q Other : <br /> 2 . Project location: X�, .,.;c. 73- <br /> Describe the project; i .e. , request being made and nature of use. <br /> Identify specific project components :- 2/•S <br /> i,710 9 - Z•0 r ,¢cmc /o 7/.r <br /> 3 . Total acreage of project: 2/ S # of existing parcels : 2. <br /> Assessor Parcel # (s ) :— /0/- 9,90- ,06 ale 07 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> ;,'Ie- S•?s 6, W els <br /> Major Subdivision - 7 - (6/86 ) <br />