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Environmental Information Form <br /> • Part B <br /> DATE: (;Pntamhar 19, 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 yy AGENT OF OWNER <br /> Name Dean G_ Gilman, G& L Engineering <br /> Address 551 N. Hunter Street, Ste 1 <br /> City Stockton, <br /> State/Zip Ca 95202 <br /> Phone (209) 941R727 <br /> A. PROJECT DESCRIPTION , <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, ElMinor Subdivision, Q Site Approval, <br /> Zone variance, Q Other : <br /> 2 . Project location: North East corner of Deitrich Rd. and Copperopolis Rd <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : Request is being made to <br /> suhdivide twn existing lnts and create a total of four lnts. A DP.V1A lnn <br /> Apr 1 i nati nn is a part of this prn nnRPH nrn iiPrf _ <br /> 3 . Total acreage of project: 9.12 Ac. # of existing parcels : 2 (two) <br /> Assessor Parcel $ (s ) : 105-220-20 and 105-220-21 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> Minor Subdivision - 7 - ( 6/86 ) <br />