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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 X AGENT OF OWNER <br /> Name Kjeldsen-Sinnock & Assoc . , Inc <br /> Address P 0 Box 844 <br /> City Stockton <br /> State/Zip Calitornia - <br /> Phone 209 946-0268 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q use Permit, Q Major Subdivision, <br /> Zone Reclassification, D Minor Subdivision, Q Site Approval , <br /> Zone Variance, Q Other : <br /> 2 . Project location: 1639 West Lincoln Road <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : <br /> To divide 0 . 8 Acres into 2 Parcels <br /> 3 . Total acreage of project: 0 . 86 # of existing parcels: 1 <br /> Assessor Parcel # (s ) : 07.7-73-'fT- <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: No <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> N A <br /> N/A <br /> Minor Subdivision - 7 - ( 6/86 ) <br />