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•1 <br /> Environmental Information Form <br /> Part B <br /> DATE: March 1990 <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 Quartaroli & Associates <br /> Address 160 Northgate Drive <br /> City Manteca, <br /> State/Zip CA 95336 <br /> Phone (209) 239-4908 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, El Minor Subdivision, Q Site Approval, <br /> Q Zone variance, [:] Other: <br /> 2 . Project location: 9659 So. Priest Road French Camn, CA 95231 <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : Divide existing 5.85 +- acre <br /> parcel into three parcels. <br /> 3 . Total acreage of project:5.85 +- Ac. # of existing parcels: one <br /> Assessor Parcel # (s ) :— 193-220-25 <br /> 4 . If *dere is an existing EIR assessing any aspect of your project <br /> site , provide title and date: None <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> Wei 1 "e�=th Dept. <br /> Septic Tank & Leach Field Fmrirnnment.a1 Haalth nP�).t <br /> Building Buildina_Dent_ <br /> Minor Subdivision - 7 - ( 6/86 ) <br />