Laserfiche WebLink
Environmental Information Form <br /> z <br /> Part B <br /> DATE : FEB, Iq 01 1167 <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 WONG- ENC-1 N EE9S - 11JC . <br /> Address_ 4-S-IA FEhTHE?- RIVER- -- SUtT'F- h <br /> City SMr-K.TotJ <br /> State/Zip C.A 9SZ.07 <br /> Phone A;�J a -nn U <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q Use Permit, Q Major Subdivision, <br /> Zone Reclassification, 5Q Minor Subdivision, Q Site Approval, <br /> Zone Variance , Q Other : <br /> 2 . Project location: S. St DE SGHUVTE P-0. NT P N TrE1zS0fJ PASS F-D. <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : <br /> RE Ph%,CEI, 3 EX15T1NG- PAR-GELS IIJT17 Ar- NEW <br /> PAVCFLS <br /> 3 . Total acreage of project: IC # of existing parcels : 3' <br /> Assessor Parcel # (s ) :- 'LOQ - ll 0 — IS _ IG A WD 17 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: ER -85-1 <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> I <br /> Minor Subdivision - 7 - ( 6/86 ) <br />