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Environmental Information Form <br /> Part B <br /> DATE: S�9 7 <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 COMPLLETING FORM PROPERTY OWNER _,AGENT OF OWNER <br /> Name ,Uyumfa�h T-,g2z w <br /> Address 3Z3 u>. <br /> City <br /> State/Zip Cu/, 9SZ447 <br /> Phone 368 - 161Gif9 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: [—] Use Permit, Q Major Subdivision, <br /> Zone Reclassification, Dl Minor Subdivision, Q Site Approval, <br /> Q Zone variance, Q Other: <br /> 2 . Project location: Dig �.S:ap �lG��iA•y � — %¢ .�%lr .yv�f.� �f�a�, ,vc <br /> Describe the project; i .e . , request being made and nature f use . <br /> Identify speccific project components : <br /> -il <br /> / rG OW/ /�Ja h 72J� A O~s! <br /> 3 . Total acreage of project: 44,-t,44- N of existing parcels : / <br /> Assessor Parcel Us ) : <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 /> A) A. <br /> Minor Subdivision - 7 - ( 6/86 ) <br />