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• Environmental Information Form <br /> Part B <br /> DATE:— 17-1 c;—R7 <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 William Duncan <br /> Address-1870 W Yosemite <br /> City Lathrop - <br /> State/Zip ca. 9533n <br /> Phone 982.-1144 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Q use Permit, Q Major Subdivision, <br /> I---a Zone Reclassification, Q Minor Subdivision, Q Site Approval, <br /> Zone Variance, Q Other : <br /> 2 . Project location: <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : Trailer Storage on rear.-of lot <br /> Philco nisposal to or--.rate their business on front portion of lot <br /> 3 . Total acreage of project: 4 acres # of existing parcels : 2 <br /> Assessor Parcel Us ) :: 195-27n-9 & 195-270-23 <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 /> Site Approval Application - 5 - ( 6/86 ) <br />