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Environmental Information Form <br /> Part B <br /> DATE: December 17, 1986 <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 Mid-Valley Engineering, Inc. <br /> Address 900 H Street #G P.O. Box 816 <br /> City Modesto, Calif. 9535 <br /> State/Zip Calif. 95354 <br /> Phone (209) 526-4214 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, F] Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, Q Site Approval, <br /> QZone Variance, Q Other : <br /> 2 . Project location: North of Quashick Road approximately 1000 f t.f rom-Highway• 99 <br /> Describe the project; i .e. , request being made and nature of use. <br /> Identify specific project components : Requesting subdivision which <br /> consists of custom homes <br /> 3 . Total acreage of project: 110.6 ac # of existing parcels: l <br /> Assessor Parcel Us ) :: 86-07-13 <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 AGENCY <br /> Tent4tive Mar Approval San Joaquin County Planning_Commission <br /> Tentative Mar Approval -San, Joaquin. County Board of Supervisors <br /> Major Subdivision - 7 - (6/86 ) <br />