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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 �,e PROPERTY OWNER AGENT OF OWNER <br /> Name /GTS Z <br /> Address f �� <br /> City r �v <br /> State/Zip S2Z� <br /> Phone o - - <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q use Permit, Q Major Subdivision, <br /> Zone Reclassification, M Minor Subdivision, Q Site Approval, <br /> Zone Variance, Q Other : <br /> 2 . Project location: <br /> Describe the project; i .e . , request being made ane nature of use . <br /> Identify specific project components : <br /> 3 . Total acreage of project: -142.111106 # of existing parcels : <br /> Assessor Parcel # (S ) :- <br /> 4 . <br /> (s ) :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 : <br /> PERMIT AGENCY <br /> Minor Subdivision - 7 - ( 6/86 ) <br />