Laserfiche WebLink
Environmental Information Form <br /> Part B <br /> DATE : June 1997 <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 Steven A HPrum <br /> Address Post nffi r•P nraujPr ?n <br /> City <br /> State/Zip 95201 - <br /> Phone 209/938-8200 - <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q use Permit, Q Major Subdivision, <br /> �] Zone Reclassification, B Minor Subdivision, E] Site Approval, <br /> Zone Variance, Other : <br /> 2. Project location: Hansen Road, Tracy Cali ornin <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : This AnDlication iG to divide <br /> A sinZIe nnrcel into two parrpls nf over tcn acre <br /> q each for <br /> rpqicl�nt-J �l use- <br /> 3 . Total acreage of project: �� # of existing parcels : 1 <br /> Assessor Parcel # (s ) : 20930-11 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: - <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 />