Laserfiche WebLink
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 X AGENT OF OWNER <br /> Name Thomason-Hysell Engineer-, <br /> Address 1016 17th Street <br /> City Mn rIP c to <br /> State/Zip falifnrnia <br /> Phone ( 209) 521-8986 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> Zone Reclassification, (Q Minor Subdivision, Q Site Approval, <br /> E] Zone Variance, LJ Other: <br /> 2 . Project location: North side of Louise Avenue - 1320± fppt Past of PrPscntt Rd <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components :-The request is to subdivide <br /> a 60.6[ acre parcel into a 59.12 and 1 -50 acre parcel The owner <br /> and his ton have Pntered into a jnint managPmPnt agrPement <br /> 3 . Total acreage of project: 60.62 # of existing parcels: 1 <br /> Assessor Parcel Us ) :: 199-37-11 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date : No <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 />