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QF <br /> CITY OF LATH R O P ZL2 <br /> Date R,/'i <br /> -�-.� Community Development Department APPY — 35 <br /> Environmental Information Form �Nng <br /> Rcc�/d by <br /> �+ Receipt Y z�iOG <br /> ,l DATE: 10 — )� l (.0OFFICE USE ONLY <br /> (To be Completed By Applicant) <br /> NOTE: In completing this form, use additional sheets if necessary. Answer all questions to the <br /> best of your ability. If a question is not applicable to your project, write NA (nc: <br /> applicable). Please do not leave blanks. Incomplete forms cannot be accepted. <br /> PERSON COMPLETING FORM: ✓ Property Owner Agent of Owner <br /> Name r. ��` �0 0 P 7 <br /> Address V-0 AT) <br /> city <br /> State/Zip L° A�—�P -' 16 '> 3 C) <br /> Phone -�--o Gt 0 Z Fax 914 8 '4 3 3 -2- <br /> A. <br /> A. PROTECT DESCRIPTION <br /> I. Type of Application: Use Permit ❑l ntative Map ElZone Reclassification ❑ <br /> Parcel Map F-1SitePlan Review Variance ❑ General Plan Amendment ❑ <br /> Other ❑ (Please Specify) <br /> 2. Project location: Z Sp Ro-r-k'� V-1c) P'-O <br /> Describe the project, i.e., request being made and nature of use. Identify specific projec_ <br /> components: (� <br /> Ft-�D �kt.J V t�+RLTvi-t�J C YL,R0T (j=-A - 1 00fL►W A►�J h�ice+ Pb.E�N't) <br /> J S T I N C- �-"C a--V S is -k.o @ 0 N O v c t- S k AA W--0 R S t M c L-42 <br /> QJ c� S I rJ dr <br /> 3. Total acreage of project: Q. 4 3 of existing parcels: l <br /> Assessor Parcel No-(s) <br /> a. If there is an existing EIR assessing any aspect of your project site, provide title and date: <br />