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Environmental Information Form <br /> Part B <br /> DATE: <br /> (To be Completed By supplicant ) <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 _ o'er, ) . , o �.2 <br /> Address 1�, �rawtia►u 1)iz- <br /> City C„lL- , <br /> State/Zip <br /> Phone z ) 74X7;-4e,,E 5 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: 0 Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, Q Minor Subdivision, E] Site Approval , <br /> QZone Variance, 0 Other: <br /> 2 . Project location: 4890 EAST ACAMPO RD . , ACAMP09 CA . <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identifsppecific roJ]ect components : " P A(;RT(111T 1PNRAT <br /> BUILDIKG TO BE US D kS A STORAGE FAC1L111 ri—F <br /> RnrTTOMinTT 11 Mn De nFRT( F T4FnT)n11ART7oe FOR ItRTne FARM RFRVT(7TN(- <br /> 3 . <br /> Tr <br /> r <br /> 3 . Total acreage of project: 1 •0 ± # of existing parcels : 20 <br /> Assessor Parcel # (s ) : n� 7_ns�n_nr <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: Nn <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project : <br /> PERMIT N/A AGENCY <br /> Site Approval Application - 5 - ( 6/86 ) <br />