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Environmental Information Form <br /> Part B <br /> DATE : SEPT T. 0 , 1966 <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 x AGENT OF OWNER <br /> Name YJONG- ENG-WEEKS WC • <br /> Address 45-78 FFATHEK- Pz1YEK DK.1VE , SUITE <br /> City GTO CKTO N <br /> State/Zip CAS q SZ0 7 <br /> Phone 4--7G-00 11 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q Use Permit, Q Major Subdivision, <br /> Zone Reclassification, El Minor Subdivision, Q Site Approval , <br /> �] zone variance, F�Q other : GENEF-AL PL.AQ N MEODPAEK)T <br /> 2 . Project location: 5300 BO&G-(ANo 9oku <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : <br /> SU5WQ1G(Q0 OF )\CK.ES INTO 14- RURAL_ <br /> F-EStDENTIAL LOTS , WITt{ R-(DI - TKAIUS <br /> 3 . Total acreage of project: 31,4-(7 # of existing parcels : <br /> Assessor Parcel # (s ) : 0 09 — OZO — 134- <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date : NOW E <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> zON1NE 7r-- M14-A0I. SOB010IS(oki COUfJTY PLflW1WG-- <br /> General Plan Map Amendment 11 ( 6-86 ) <br />