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Environmental Information Form <br /> Part B <br /> DATE: ',-PPtPmhPr 1 , 1989 <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 XL_—PROPERTY OWNER AGENT OF OWNER <br /> Name Frankie B . Rieger <br /> Address 8711 VeritasAve . <br /> city Manteca <br /> State/Zip CA 95336 <br /> Phone 209-239- <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> Zone Reclassification, )EI Minor Subdivision, El Site Approval, <br /> Zone variance, D Other: <br /> 2 . Project location: 16 9.9 S % Hgr13n Rd I9thrnQ <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : Parrpl Split & <br /> Lie-d-i-p-gtg'9'� t.rpPmtn San .1nacu i n County <br /> 3 . Total acreage of project: � p7 # of existing parcels : 1 <br /> Assessor Parcel # (s ) : 1c5-?4n-'1 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: NnnP KnnWn <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> Fang Rggwirbd Until nevPlnnmPnt of Property <br /> Minor Subdivision - 7 - ( 6/86 ) <br />