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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 /> NameJOHN & JUDY LARSON, JR. , MIKE & SHERELYN MADUENA, ERWIN & DAROLYN PERRY <br /> Address 333 SAN CARLOS WAY, SUITE B <br /> City STOCKTON <br /> State/Zip CALIFORNIA 95207 <br /> Phone 209-473-4444 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> X� Zone Reclassification, Q Minor Subdivision, Q Site Approval, <br /> Zone Variance, Q Other : <br /> 2 . Project location: 1341 & 1351W. HAMMER LANE <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : 8000 SQ. FT. INSURANCE <br /> OFFICE BUILDING <br /> 3 . Total acreage of project: # of existing parcels: <br /> Assessor Parcel # (s ) : 075-220-35 & 075-220-37 , LOT 10 AND ii <br /> BLOCK 11 OF TRACT #115 COLONIAL HEIGHTS <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 /> Zone Reclassification - 7 - (6/86 ) <br />