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Environmental Information Form <br /> Part B <br /> DATE : S- O 7- ,99 <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 FORMPROPERTY OWNER —AGENT OF OWNER <br /> Name 7:�"gYl D L - HA2JZIS <br /> Address pp <br /> City <br /> n D E STa <br /> State/Zip CA ID S3 SC) <br /> Phone 7-09 SZCo 97Z <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q Use Permit, Major Subdivision, <br /> Zone Reclassification, Z] Minor Subdivision, 0 Site Approval , <br /> Zone Variance, Q Other : <br /> 2 . Project location: -&335Q <, 4L45T//4 TZD. KIR60 Ca <br /> Describe the project; i .e . , request being made and nature of use . <br /> Ident/ify specific project components : -,/-o SCAa/'c. e 6m4-- <br /> 6-007 -er Di7 a <br /> o a L414,?z- z2eW741-ee,5 117 <br /> 3 . Total acreage of project: 2/. 5 # of existing parcels :-0/S/6' <br /> Assessor Parcel # (s ) : 243- ZGO -Z7 <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 : <br /> PERMIT AGENCY <br /> Minor Subdivision - 7 - ( 6/86 ) <br />