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Environmental Information Forin <br /> Part B <br /> DATE : 10 �l� g <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 Dillon Engineering <br /> Address 1820 W. Kettleman Ln. <br /> City Lodi <br /> State/Zip Ca.. 95242 <br /> Phone (209) 334-6613 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application : Q use Permit , Q Major Subdivision , <br /> Ev-1 Zone Reclassification, 0 Minor Subdivision, FSite Approval , <br /> QZone Variance , Q Other : <br /> 2 . Project location• N.E. Corner of Guild Avenue and Lockeford Street <br /> Describe the project; i . e . , request being made and nature of use . <br /> Identify specific project components : <br /> 3 . Total acreage of project: ± 4.9 # of existing parcels : 1 <br /> Assessor Parcel # (s ) :-049-54-0-06 <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 /> Zone Reclassification 7 - ( 6/86 ) <br />