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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 X PROPERTY OWNER AGENT OF OWNER <br /> Name DONALD KENNEDY <br /> Address 4421 Clark Dr <br /> City Stockton <br /> State/Zip California 95205 <br /> Phone z1 (o— <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, Q Other : <br /> 2 . Project location: 4491 ('1 ark nriup <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : <br /> RPnla(-P fire lnss 50x80 and 20x80 C'aL- 1,a0 ) <br /> Os-d iVFi� <br /> 3 . Total acreage of project: 6 _7R # of existing parcels : 1 <br /> Assessor Parcel # (s ) : <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 /> none <br /> Site Approval Application - 5 - ( 6/86 ) <br />