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Environmental Information Form <br /> Part B <br /> DATE : April 24,. 1987 <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 MID-VALLEY ENGINEERING, INC. <br /> Address P.O. Box 816 <br /> City Modesto <br /> State/Zip California 95353 <br /> Phone (209) 526-4214 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> Zone .Reclassification, D Minor Subdivision, Q Site Approval , <br /> QZone Variance, Q Other: <br /> 2 . Project location: 30907 30903 and 28218 S. Koster Road- Tra r�4, rA1JfnrnJA <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identifysppecif is pro]ect components : The proposed major subdivision will <br /> consist of 1Z single family residential lots not less than 1 .5 acres each. <br /> 3 . Total acreage of project: 20.06 # of existing parcels : 5 <br /> Assessor Parcel # (s ) : 255-110-42, 255-110-85 255-110-87. 255-110-88 and <br /> 255-110-89 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: Not applicable <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> NOT APRUCABLE <br /> Major Subdivision - 7 - (6/86 ) <br />