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Environmental Information Form <br /> Part B <br /> DATE • <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 AGENT OF OWNER <br /> Name <br /> Address -Pre��s Co,-oma<lo <br /> City - <br /> State/Zip G� ASao <br /> Phone <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: use Permit, [:] Major Subdivision, <br /> Q Zone Reclassification, 54 Minor Subdivision, Q Site Approval , <br /> Zone variance, E] Other : / <br /> 2 . Project location: <br /> Describe the project; i .e . , request bei n made and nature of use . <br /> Identify specific project components : �d <br /> /2� a o5 <br /> le S . <br /> 3 . Total acreage of project: # of existing parcels : <br /> Assessor Parcel # (s ) : /0-3 4100 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: /UOYl2 <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 />