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Environmental Information Form <br /> Part B <br /> DATE : fi <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_ ?� <br /> Address— ;Pr, c>�� 7 <br /> City STocrTv.✓ <br /> State/Zip 2,4 9SZ � , <br /> Phone -{6s'- oF?/ <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Use Permit, Q Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, Q Site Approval , <br /> QZone Variance, Other : G'.� 0�AJ-r-n0j44-r-AJ;- sc- co�r/4rr�L� �Ezo✓� <br /> 2 . P r o j e c t to c a t i o n �e- /ti oif fT 2T-z-✓-D /n4- C,4 <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : <br /> 3 . Total acreage of project: <,&3 # of existing parcels : otile- <br /> Assessor Parcel # (s ) : zs'3 - Z oo - 38D <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 : 1,�Aje <br /> PERMIT AGENCY <br /> Zone Reclassification - 7 - ( 6/86 ) <br /> .y <br />