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Environmental Information Form <br /> Part B <br /> DATE : -Vi U Fc 87 <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 CCMPLETING FORM PROPERTY OWNER _AGENT OF OWNER <br /> Name WOf G& EMG-INEEV-S l INC• <br /> Address ¢578 FEAT)-(EIz F-IVEK DR.. SUt-FE A <br /> City $TOCKTON) <br /> State/Zip CA 9S-L01 <br /> Phone A--1 c —0011 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q use Permit, Q Major Subdivision, <br /> Zone Reclassification, r& Minor Subdivision, Q Site Approval , <br /> Zone Variance, Q Other : <br /> 2 . Project location: <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : TO 161UIDE OFF A <br /> 3 AC.R-E PAR.cEL FFON\ a 4-5 4-S NCj?-E f N V-rE7c- <br /> 3 ACRE PARCEL. WTMM XIST(t-1(5r- h10thE CSF MARK- <br /> VAN G-RONINCrEtJ VICE MES. OF \MW G-KOJI"G-EN ORCHARDS <br /> 3 . Total acreage of project: x-5,4-5 # of existing parcels : <br /> Assecsor Parcel Us ) :: -Li-5 09 0 — 0-?) <br /> 4 . If there is an existing EIR assessingany aspect of your project <br /> site, provide title and date : NO F <br /> 5 . Other permits—abd approvals (County, Regional , State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> NONE <br /> Minor Subdivision - 7 - ( 6/86 ) <br />