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Environmental Information Form <br /> Part B <br /> E <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 X PROPERTY OWNER AGENT OF OWNER <br /> Name Calvin Mettler <br /> Address 15905 N. Locust Tree Road <br /> City Lodi <br /> State/Zip CA 95240 <br /> Phone 368-1245 ` <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, Efl Minor Subdivision, Q Site Approval , <br /> Zone variance, Q Other : <br /> 2 . Project location: Locust Tree Road - 3/4 mile N. of Kettleman Ln. <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : Create parcel for owners retirement <br /> and sell remainder. <br /> 3 . Total acreage of project: 80 # of existing parcels : 1 <br /> Assessor Parcel # (s ) : 051 Tn--n— <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 : None <br /> PERMIT AGENCY <br /> Minor Subdivision - 7 - ( 6/86 ) <br />