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Environmental Information Form <br /> Part B <br /> DATE: <br /> (To be Completed By Applicant ) <br /> NOTE : In completing this form, use additiohal 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 S�c�li".f !� Scq �ca/ •- �Ssoc. <br /> Address 4Le4✓ Co�o.»do <br /> Cit y -517X04 �rbrl <br /> State/Zip el-4 sLa4 <br /> Phone -10 L/ <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q Use Permit, D Major Subdivision, <br /> Zone Reclassification, [K Minor Subdivision, Q Site Approval, <br /> Zone Variance, Q Other : <br /> 2 . Project location: $./if/. Com nay- J��To-e/� 1 �o�pc�a�a/is •Pds <br /> Describe the project; i .e . , request being made and nature of use . <br /> Id//entify specific project components : G'rPz�c Z <br /> /70.h —517c5 <br /> 3 . Total acreage of project: 36 .4G # of existing parcels : <br /> Assessor Parcel Us ) :: /o3-Z3 - a3 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: /UO�VE <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> /1�0 ii/E <br /> Minor Subdivision - 7 - ( 6/86 ) <br />