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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 — C�AGENT OF OWNER <br /> Name W rf-V-e <<' 17S�'L <br /> Address CJ v r f^ <br /> City f7, <br /> State/Zip 3 �� <br /> Phone u'Y Z 3`1- qo b <br /> A. PROJECT DESCRIPTION <br /> 1.. Type of application: Q use Permit, Major Subdivision, <br /> [� Zone Reclassification, Q Minor Subdivision, [] Site Approval, <br /> Zone Variance, r,,�-,,r other: tle-/i" 4- <br /> 2 . Project location: / C/� tees_ "t� <br /> Describe the project; i .e . , request bei n made and nature of use . <br /> Identif specific pr 'ect componen S . , s < e5! <br /> o -D 11v�;��. S,' <br /> ��s t % 'tj e> s" ;1 ,It?va lK 2;-t" <br /> T 4-�4x;l T- <br /> 3 . <br /> 3 . Total acreage of project: ` /. (� # of existing parcels : � - <br /> Assessor Parcel # (s ) : iv - ZT- — Cy <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: �sZ <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> 1,14 1 114 <br /> Mobilehome/Recreational <br /> Vehicle Park Permit - 11 - (9/86 ) <br />