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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 �N G <br /> Address +c5 -76 TFtYY2 4 U�2- h I- ALA <br /> City N <br /> State/Zip l,4 r'' '1 <br /> Phone ( 00[ / <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application : 151 Use Permit, Q Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, 0 Site Approval , <br /> Zone Variance, Other : <br /> 2 . Project location: Gj .lam Gp(L FCtemW <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : P&t:yQC__?E0 -Muc c- <br /> P�-CL�t <br /> 3 . Total acreage of project: + = of existing parcels : <br /> Assessor Parcel # (s ) :—�4�, - �{ - '� & 4,-1 14:2D - � -r <br /> 4 . If there is an existing EIR assessiany aspect of your project <br /> site , provide title and date : 0 'I <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project : <br /> PERMIT PAI, AGENCY <br /> Use Permit Application - 7 - ( 6/86 ) <br />