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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 . Incomple`e forms cannot be accepted. <br /> NzroEn---- <br /> PERSON COMPLETING FORM X PROPERTY OWNER AGENT OF OWNER <br /> Name JOLL17�-D GEF l J(--Q <br /> Address �J3C7S`� (_-Lti � -C-AUVe <br /> City <br /> State/ZiC14-5 <br /> Phone <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application : use Permit, Major Subdivision, <br /> Zone Reclassification, Y] Minor Subdivision, .0 Site Approval , <br /> Zone Variance, Q Other : <br /> 2 . Project location: 15�f"IO EP-Si l�i�e"12'rl2OAS� <br /> Describe the project; .i .e . , request being made and nature of use . <br /> Identify specific project components : M1tJOtLSuc3D��ltStotJ O�Two <br /> t(oo A.c cis 7-20 nn P.?Atz c.tz <br /> PA2c�s <br /> 3 . Total acreage of project: 4,"-,r--)10I # of existing parcels : I <br /> Assessor Parcel # (s ) :- CZ-L a0 -01 <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 : t-,JpNE tJA <br /> PERMIT AGENCY <br /> Minor Subdivision - 7 - ( 6/86 ) <br />