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Environmental Information Form <br /> Part B <br /> DATE : OCT- I <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 _AGENT OF OWNER <br /> Name WOM& ENG WEE-K,,L WC. <br /> Address 4-578 EEATttEK F-tVEr C�,F-IVE % SU(TE: A <br /> City S TV C-KTD I <br /> State/Zip C& 4 St <br /> Phone J--J(; --n n <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, Q Site Approval , <br /> [� Zone variance, N Other: VLAtJt Eb DtSTK►CT <br /> 2 . Project location: E. S►c�E 8UG{r il\tJO "AD <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : <br /> I - L-OT ESTATE TTFE SU Div1S101J W►TH <br /> R.(t)11Q T- YKA ► LS <br /> 3 . Total acreage of project: 31• # of existing parcels : <br /> Assessor Parcel # (s ) : 08 9 -0 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: NONE. <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> (vMA,OF- SLA3u1V(S(01Q COUNTY PLANtJ► NG. <br /> Planned District - 19 - ( 8/86) <br />