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EnvironImentA infa�rma an Form <br /> Part B <br /> DATE: J <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 OWNERAGENT OF OWNER <br /> .Name bVAJ *40f-kk r?SsoC-,,g7-Fs <br /> Address V/ 7 _ <br /> City' T �✓ <br /> State/Zip__S,4 4Sao/ <br /> Phone coq <br /> A PROJECT DESCRIPTION <br /> 'Typeof application : use, Permit,;: Major Subdivision, <br /> Q Zone Reclassification, 5411Mino.r Subdivision, Site Approval , <br /> Q Zone Variance Other <br /> 2. 'Project location:, s ey.+,✓ Rb. - 51Z r sEd .J �r�ao Fi" rr-.*sr vF <br /> Describe the project;. i.e . request being made and nature of use. <br /> Identify, sP..ec.ifi:�-_ _pr.oject components : crr rw, pAge_c4_$ <br /> _9 ice p�Rcct QAIE PAftt-� ckE,tr z �NRLL8r1 �� �dr��5 A.✓� 1% rb a� <br /> t F As 7W-1 [+A✓ticF/c-yPcic.+rrr,p pF TNS` JC.�n/aN EJ/,�/Cfl <br /> S qA Lz. ,s, T)Yr u s<_ e F 7YE' '-E"iu�¢r�//✓& 3 R'lz f1 c rz Es <br /> 3 . Total acreage of project: sfp # of existing parcels: o�VE <br /> l.ssessor Parcel Us ) :: ay-2 - /b0 - I7 <br /> 4'. If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: Aim <br /> 5 Other permits and approvals (County, Regional; State and federal ) <br /> :required for this project : MIA/, <br /> PERMIT AGENCY <br /> i <br /> t <br /> Minora Subdivision 7 - ( 6/86 ) <br />