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• Environmental Information Form <br /> Part B <br /> DATE: October 31 , 1988 <br /> (To be Completed By Applicfant) . <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 /> a PERSON COMPLETING FORM PROPERTY OWNER X AGENT OF OWNER <br /> Name Dan Thompson Thompson-Hvsell Engineers <br /> j Address 1016 12th Street <br /> City Modesto <br /> State/Zip California, 95354 <br /> Phone (209) 521-8986 <br /> 4 <br /> 1 A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, Q Minor Subdivision,; Q Site Approval, <br /> Zone Variance, Q Other: <br /> 2. Project location: East Side Harlan Rd, North Of Squires Rd. <br /> Describe the project; i.e. , request being made and nature of use . <br /> y Identify specific project components : Creating 50 acre parcel for <br /> potential sale and leaving a Remainder Parcel of 1 19.4 acres. <br /> 3 . Total acreage of project: 169.4 # of existing parcels: 2 <br /> Assessor Parcel Us ) :: 195-03- 11 , 12, 14 , 16, 17 18 23 <br /> 4o If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: N/A <br /> 9 <br /> 5 . Other permits and approvals (County, Regional, State and Federal) <br /> required for this project: <br /> PERMIT AGENCY <br /> N/A <br /> I <br /> Minor Subdivision - 7 - ( 6/86 ) <br />