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l Environmental Information Form <br /> Part B <br /> DATE: July 17, 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 AGENT OF OWNER <br /> Name <br /> Address <br /> City <br /> State/Zip <br /> Phone <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q use Permit, Q Major Subdivision, <br /> l---a Zone Reclassification, Q Minor Subdivision, FJ Site Approval, <br /> Q Zone variance, Q Other: <br /> 2 . Project location: 2314 Hollenbeck Road; N.E. of Hwy. 4 and Jack Tone Rd. <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : Request allokvance for <br /> home occuoancv slaughtering house. _rection o pasture and <br /> pens , 1,iHing shed. <br /> 3 . Total acreage of project: 117.6 Ac. # of existing parcels: One (1) <br /> Assessor Parcel Us ) :: T6-03 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: N/A <br /> 5 . Other permits and approvals (County, Regional, State and Federal) <br /> required for this project : <br /> PERMIT AGENCY <br /> Site Approval Application - 5 - ( 6/86 ) <br />