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 PROPERTY OWNER ✓ AGENT OF OWNER <br /> Name t/O`in A41-o e S <br /> Address 2 C14 <br /> City 1'knan cca., CA <br /> State/Zip C,4 9 S' :3 4 <br /> Phone ZOq) rZ 3- G406 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q use Permit, Major Subdivision, <br /> -Zone Reclassification, 0 Minor 'Subdivision, Q Site Approval, <br /> QZone variance, Q Other: <br /> 2 . Project location: <br /> ,a-fh 0./, ecii raa/c� oY, Esq/�. B��/o ed benlW<� <br /> Describe the project—; i-.6-. 'J -r64V-estf being made and nature of use . <br /> Identify specific project components : %v dii/ig/t O Zo. rAc <br /> i ti CT a rc a& 42Q S�A&- <br /> 3 . Total acreage of project: ZD.S 4r. # of existing parcels : � <br /> Assessor Parcel * # ('s ). Zb7 -"ZOO -/ D <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 l AGENCY <br /> Minor Subdivision - 7 - ( 6/86 ) <br />