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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 Baumbach $ Piazza, Inc. <br /> Address 323 West Elm Street <br /> City Lodi <br /> State/Zip CA 95240 <br /> Phone 368-6618 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, X� Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, 0 Site Approval , <br /> Zone Variance, F-1 Others <br /> 2 . Project location: 5080 E. Eight Mile Road, Lodi, CA <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : Construct two streets, public <br /> well and connect water and storm drain to adjacent subdivision. <br /> 3 . Total acreage of project: 17.2-- # of existing parcels: 1 <br /> Assessor Parcel # (s ) : X70 1 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: None Known <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> Grading San Jnanuin Cn RiTildingDent <br /> Water F, Septic San Joaquin I c.,g] Health Di-trict <br /> Subdivision Inrorovement San Joaquin Co Dent Qf p„hl „- Works <br /> Major Subdivision - 7 - (6/86 ) <br />