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Environmental In#orrnation Form <br /> Part E3 <br /> DATE : 121/19 /B7 <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 i'Dnst- Off inn Pn- 11 QP" 79 East I I th St-pe' <br /> City _• Tracv • <br /> State/Zip ra i if nrnia <br /> Phone 91 A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q Use Per .i t , Major Subdivision, <br /> r-'71 "Zone Reclassification, Q Minor Subdivision, [:] Site Approval , <br /> Zone Variance, [—] Other : <br /> 2. , Project location: Assessors Parcel No ' s <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project', components : Proposal includes two Marinas, <br /> -Restaurant/Bar, Boat Renta!-'& 'Re-pair , Boat ShoQ 11ini -Mari- • Pe <br /> creational vehicle—storaq'e, 350 M/L• Camp sites , � 337 snacp Mobile <br /> Home, Park. - <br /> 3 . Total acreage of project: 3822 L'' of existing parcels : 1• <br /> Assessor Parcel # (s ) : 211-110-05 -and 211=110-06 . <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date : ..No . <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> N/A <br /> General Plan Map Amendment 11 ( 6-86 ) <br />