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Environmental Information Form <br /> - <br /> Part , B <br /> DATE: <br /> n (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 ' Deal �tos�Ele tfSsoo,,9�-cs ... ... <br /> ` -Address ro,:. $oA Si <br /> :City <br /> State/Zip SA95d?o/ <br /> 'Phone =of- y6_<-C)7.7 <br /> A: PROJECT DESCRIPTION <br /> 1.. <br /> Typer' of. application . Q Use. Permit, 0 Major Subdivision, <br /> ; Zone Reclassification, Minor Subdivision, Q Site Approval , <br /> x :Zone Variance,`[] Other: . <br /> 2. t Pro j$ct `:,location: SEyA,✓Rb - So�c7W slbr s46A - 6-oB:FT �.Fsr`.o� w. 1rb <br /> -,Desctibe , the project; i.e. , . request being made-and nature of qse. <br /> ` dentify.�spe.c Mf project components : ��r� ruvv PMRtZI-s <br /> SIO A' eE PA12GCt J d�J6 �AftC�L Ckf�T6D SHAGLar!�z .�dXZ5 AAA ""';S ny <br /> t«-•• �S A Ho•�4E siT� <C.!' THE ��JNeF�c OPE/rA771.�1 e< rNE R'AA-1N &11VYZd1 <br /> ' <br /> #A 4.4 Zr 71YE USg: OF WE .e-Ad!;e .✓G AG2ES - <br /> Y 3 .' Total._ acreage of project: �{O of -.existing . parcels: oNE' <br /> Assessor .,Parcel, # (s ) : aY3 -!bo - 17 <br /> 4 : xf"there is '. an'existing`=EIR ,assessing any aspect` of 'your ` project <br /> gite .provide.. title~and.: date: �//e <br /> :•_5 --Othdk., permi't§ and approvals : (County;`' Regional; State,, ands Federal)' <br /> required for this' project: N4/✓F <br /> AGENCY <br /> PERMIT, _ <br /> 7, 6 8 <br /> ) <br /> Minor; Subdivision ` <br /> T ........ _ <br />