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Environmental Information Form <br /> Part B <br /> DATE : N <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 ques ion <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 OWN]'.R <br /> Name C14l es .D NuSO 4-� G/D /1�0/271�/1] T!4 C0 <br /> Address / 30 LI4,gr" 13a.4 t5Lva <br /> City c <br /> State/Zip S SktL <br /> Phone qcq- I&C)0 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, [j] Major Subdivision, <br /> Q Zone Reclassification, M Minor Subdivision, E-! Site Approva , <br /> Zone variance, Q Other : <br /> 2 . Project location: / 516E 4#1ts p6 S,1 6E TW EEN �4/t � � r-To�F <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify s.pecif is project components : Ml&.)o2 5S06i>viSioL, iGA- <br /> f-v TV A6 .Z-,uA U S T2.w L U.S& <br /> 3 . Total acreage of project: 803 + # f existing parcels : <br /> Assessor Parcel # (s ) : /'19 • 0'2.0 -OZ /� �`' /�/-0qo - / /Z- <br /> 4 . If there is an existing EIR assessing any aspect of your projec <br /> site , provide title and date : N�r9 <br /> 5 . Other permits . and. approvals (County, Regional , State and Federa ) <br /> required for this project : <br /> PERMIT AGENCY <br /> U <br /> u rvT`c r 5 71A F S oL F p,'2av4 L oY. <br /> Major Subdivision - 7 - (6/H ) <br />