Laserfiche WebLink
Environmental Information Form <br /> Part B <br /> DATE : (2aA j <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 PtT 6� <br /> Address vwZ CL. k1 <br /> City ( CA <br /> State/Zip ( 2.(0 <br /> Phone <br /> A . PROJECT DESCRIPTION <br /> 1 . Type of application : Q Use Permit, Q Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivisions, Q Site Approval , <br /> QZone Variance , Q Other : � � I4/'► � N� <br /> 2 . Project location: V SI O�F .Tf,r,0i-t,Ui OF �7125bN P 5 <br /> Describe the project; i .e . , request being made and nature of use . fZD• <br /> Identif specific project components : <br /> CSG -Sk <br /> 3 . Total acreage of project: '2EE %C,-#' of existing parcels :- _ <br /> Assessor Parcel <br /> 4 . If there is an existing EIR assessing any aspect f your project <br /> site , provide title and date : �k�, R�12T ��-- .�' � ,fkU(0�-"1. 1`l�to <br /> 5 . Other permits and approvals (County , Regional , State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> Zone Reclassification - 7 - ( 6/86 ) <br />