Laserfiche WebLink
Environmental Information <br /> 2: 3 <br /> For Staff Use Only <br /> File No . (NC-- E)5 -( 0 <br /> Date Filed ZIP <br /> APPLICATION FORM PART B: <br /> ENVIRONMENTAL INFORMATION <br /> (To be Filled Out By Applicant ) <br /> NOTE : In completing this form, use additional sheets if necessary. <br /> Answer all questions to the best of your ability. If 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 Dan Thompson - Thompson-Hysell Engineers <br /> Address 1016 12th Street <br /> City Modesto <br /> State/Zip CA 95354 <br /> Phone 209 521-8986 <br /> TYPE OF APPLICATION Contract Cancellation (Williamson Act Non-Renewal ) <br /> PROJECT Dell 'Osso Property - Highway Service Project <br /> OTHER PERMITS AND APPROVALS (COUNTY, REGIONAL, STATE AND FEDERAL) <br /> REQUIRED FOR THIS PROJECT <br /> PERMIT AGENCY <br /> Use permit San Joaquin County <br /> General Plan Amendment & Rezone San Joaquin County <br /> -1- ( 9/85 ) <br /> Plan-44 (12/85) <br />