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Environmental Information Form <br /> Part B <br /> DATE :— - 0-S7 <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 <br /> Address <br /> City �j{��lC <br /> State/Zip <br /> Phone <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Use Permit, Q Major Subdivision, <br /> Zone Reclassification, �4 Minor Subdivision, El Site Approval, <br /> Zone Variance, Q Other : <br /> 2 . Project location:_ /�j�, <br /> Describe the project; ' .e . , request -being made and nature of use . <br /> Identify specific project components : _Ston, <br /> �O e P /sem G�lo1�J ✓G,�//�..rd�t� <br /> 3 . Total acreage of project: ZO-CSL # of existing parcels : <br /> Assessor Parcel # (s ) : /D3 - zo -// <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: G /�Afaw,-I <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> Minor Subdivision - 7 - ( 6/86 ) <br />