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Environmental Information Form <br /> Part B <br /> DATE • 01 /04/89 <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 KJELDSEN-SINNOCK & ASSOCIATES. , INC. <br /> Address P. O. Box' 844 <br /> City Stockton <br /> State/Zip Ge rnla gSZol - 084+ <br /> Phone 209-946-0268 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: [:] Use Permit, Q Major Subdivision, <br /> �--I Zone Reclassification, Q Minor Subdivision, Q Site Approval, <br /> Zone variance, Q Other: <br /> 2 . Project location: Fine Road and Comstock Road <br /> Describe the project; i.e. , request being made and nature of use . <br /> Identify specific project components : to divide 120.961 acres <br /> of Agricultural lana into 2 parcels. Parcel 1 to be <br /> gricu ura in use & j17.96 ' ana Parcel 2 to be residential <br /> in use and 3. acres <br /> 3 . Total acreage of project: 120.961 # of existing parcels: 1 <br /> Assessor Parcel # (s ) : AVN 091 -40-01 <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 /> NQN E <br /> Minor Subdivision - 7 - ( 6/86 ) <br />