Laserfiche WebLink
Environmental information Form <br /> Part B <br /> DATE: 'INW. 15� 196 <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 X AGENT OF OWNER <br /> Name woo ENCr1NE.ERS 19C. <br /> Address 4-518 FEATHER ►VEF- tA-%0E SUITE A <br /> City 9TOCKTON <br /> State/Zip Ch 2 520-7 <br /> Phone 4-1C- --0011 - <br /> i <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application:. Q Use Permit, Q Major Subdivision, <br /> QZone Reclassification, Q Minor Subdivision, Q Site Approval, <br /> Zone Variance, Q Other : <br /> 2. Project location: E SIDE FII-BERT ST. N• OF CHEP-O KEE <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : <br /> 3 . Total acreage of project: 0.3-- # of existing parcels : <br /> Assessor Parcel Us ) :: 119 1A00— c5g <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: y10 N E- <br /> 5 . <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> NONF <br /> Minor Subdivision - 7 - ( 6/86 ) <br />