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Environmental Information Form <br /> Part 8 <br /> DATE : December 28, 1987 <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 Mi)c(- Gi17(111,r <br /> Address P.O, Pox 2083 <br /> City Manteca <br /> State/Zip California, 95335 <br /> Phone 209-599-4251 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application : x] Use Permit, Q Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, Q Site Approval , <br /> QZone variance, E] Other : <br /> 2 . Project location: 11651 Palm Ln. , R pon , California 95366 <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : <br /> See attached documents <br /> 3 . Total acreage of project: .85 # of existing parcels : N/A <br /> Assessor Parcel # ( s ) : 243--240-04 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date : N/A <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> N/A <br /> Use Permit Application - 7 - ( 6/86 ) <br />