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Environmental Information Form <br /> Part B <br /> DATE : SANuAIZ,1 I9 ITS9 <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 tri tr 1n14cw4 v v <br /> Address 7ou> CA41ic-P-it11A <br /> City 'Le C79,4 oN <br /> State/Zip CA 953 20 <br /> Phone 2 0 4 9--3t3 - .3'f19 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q use Permit, Q Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, dSite Approval, <br /> Q Zone variance, Q Other: <br /> 2 . Project location: EScA�o1.I _ $c«��A ,Qo1gD -,qp:1 ,�Io• .Zo7-320-/3 <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : SToc,e.i.a�n moa cA7T�€ saes. <br /> A41AI Bi 1LOi^14 ?+ Gv.lTA7n/ A LTIO\i PIAIA ��S T PdOAIS AA1,0 <br /> /PE r.OUP_�.uT• SELo ✓p r7:GItD�Jf. IfAer - _fTP.cacT.a2�_ as✓[,L_ To__ tlous� /ai✓:.,,ALS <br /> ZAIR1a r'3 f2)Ll�i�7t Ix i7JIL111n1r. 41&8-1' 7,6 MIZAAN✓ L?E'Qaig/"/4 4 i <br /> 3 . Total acreage of project: 14, wl Ac # of existing parcels : 6A11:57 <br /> Assessor Parcel # (s ) :- ,2 6 7- 320 - /3 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: AIe - zz>1✓1., 4 6A Io <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> _ �:l1LDiTlG. e0z�c2ln '7- <br /> Site <br /> TSite Approval Application - 5 - ( 6/86 ) <br />