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Environmental information Form ' <br /> Part B <br /> DATE : 3 — Z — <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 /> PERSOb'. CCMPLETING FORM V/ PROPERTY OWNER AGENT OF OWNER <br /> Name 4-u f n P <i f5 C <br /> Address 01/ �i�r(' /ICY <br /> City <br /> State/Zip <br /> Phone_ <br /> A. PROJECT DESCRIPTION <br /> 1� Type of application: Use Permit, Major Subdivision, <br /> Zone Reclassification, E�J Minor Subdivision, Site Approval , <br /> Ell Zone Variance, E] Other : <br /> L . Project l o c a t i o n: We /S/�(' o1,--11a/I i��4ce 'l /YI/� <br /> Describe the project; i .e . , request being made and nature or use . <br /> Identify specific project components : <br /> ,y�p 3C%CO Sy/�% /�r�nE �/"�/1�' 1�yF�/ u� S-��� SiS �•�� - �� j ; <br /> Total acreage of project:_ # of existing parcels : <br /> Assecsor Parcel # (s ) : (_�r3 -,270-02_ - <br /> u „ If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: /1/ 6 <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 />