Laserfiche WebLink
Environmental Information Form <br /> Part B <br /> DATE : <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 X PROPERTY OWNER AGENT OF OWNER <br /> Name Ronald Ferraro <br /> Address 1.5278 North Jacktone Road <br /> City Lodi <br /> State/Zip CA 95240 <br /> Phone 368-5804 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, �=! Minor Subdivision, Q Site Approval , <br /> Zone variance, Q Other: <br /> 2 . Project location: Northwest corner of Tokay Colony � `Fully Roads. <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : <br /> 3 . Total acreage of project: 52 + # of existing parcels : 1 <br /> Assessor Parcel Us ) : ()fiS-ngn-n-j <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: None <br /> 5. Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> � 7ee County P.M.# 84179 <br /> Minor Subdivision - 7 - ( 6/86 ) <br />