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Environmental Information Form <br /> Part B <br /> DATE : �Z� 8� <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 X PROPERTY OWNER AGENT OF OWNER <br /> Name S CfC / <br /> Address 2 2 4S <br /> City <br /> State/Zip <br /> Phone 5-- <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application : Use Permit , 0 Major Subdivision, <br /> Zone Reclassification, K Minor Subdivision, Site Approval , <br /> Zone Variance , D Other : / <br /> 2 . Project location: r2hlw s f ��PF" (1> !fOLI� <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project com onents : <br /> lLp 3 G7lr�zi'om <br /> X2/2 177 EF-5 17'e— e-,oP- <br /> 3 . Total acreage of project: QD # of existing parcels : <br /> Assessor Parcel # (s ) : 007— 0 90 - 05 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: &JD <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 />