Laserfiche WebLink
Environmental information Form <br /> Part B <br /> DATE <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 `t a <br /> State/ ip <br /> Phone -2 ''i. <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Use Permit, Q Major Subdivision , <br /> ® Zone Reclassification, Q Minor Subdivision, [:] Site Approval , <br /> Zone variance, Other : <br /> 2 . Project location: � L,g��< E <br /> Describe the project;• i .e . , request being mace and nature o_ use . <br /> Ider.tiyy specific project components :a24 / �r`iI-� 'E <br /> 3 . Total acreace of project:/If/.� T of existing parcels : <br /> Assessor Parcel = (s ) <br /> 4 . if there is an existing _IR assessing any aspect of your pr,cject <br /> site , provide title and date: <br /> 5 . Other permits and approvals (County, Regional , Sta..e and Federal ) <br /> recuired for this prcject . <br /> pERu?T AGENCY <br /> Zone Reclassi=icaticn <br />