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o-nvironrnentai information Form <br /> Part B <br /> DATE : December 16 . 1988 <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 Schack & Company , Dan R. Schack <br /> Address 628 rPntral AyenllP <br /> City Trary <br /> State/Zip Ca 95376 <br /> Phone 835-2178 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, Q Minor Subdivision, Q Site Approval, <br /> Q Zone variance, Q Other: <br /> 2. Project location: 24775 S Chrisman Road.- Tracy , CA <br /> Describe the project; i.e. , request being made and nature of use . <br /> Identify specific project components : RPQIIPct an AQrin111t1Jr;;.1 <br /> hnmp-,itP parDPl hp Snlit nff lgrgor QarrPl fnr cnn nf -nwnar <br /> 3 . Total acreage of project: 32 _?5 (# of existing parcels: 1 <br /> Assessor Parcel Us ) : 237-n5n-11 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: NnnP <br /> 5 . Other permits and approvals (County, Regional, State and Federal) <br /> required for this project: None until new residence is built , then: <br /> PERMIT AGENCY <br /> septiirr sYstPm HPa' th DPnfi <br /> New R si dpnrp Riii 1 di n8 Ds- ,t - <br /> Minor <br /> t _Minor Subdivision - 7 - ( 6/86 ) <br />