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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 PROPERTY OWNER X AGENT OF OWNER <br /> Name 7'jnn MrnlPr' A ,nc.i ci feS <br /> Address Po Btu <br /> City J4-r�c e-+t'�y-) <br /> State/Zip CA qr�--2p) <br /> Phone (zn-q (410 - XB3I <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q Use Permit, EJ Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, Q Site Approval, <br /> Zone Variance, Other : r,���-ni �Ic�n A rnn-{Me-n <br /> 2 . Project location: Hiohrxrt / 33 Q+ ar m F6.r-r-y �9 . <br /> Describe the projec , i .e. , request being made and nature of use . <br /> Identify specific project components : <br /> 3 . Total acreage of project:�E_ S E� # of existing parcels : I <br /> Assessor Parcel Us ) :: - I� -O 1 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: ,je? <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> + TI <br /> -`.fff-rLLcL4-i\/c-- Map C -P <br /> iannind <br /> General Plan Map Amendment 11 ( 6-86 ) <br />