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Environmental information Form <br /> Fart B <br /> DATE: FPhnia= ?4L, 1 qRR <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 Duartaroli and Associates <br /> Address 160 Northgate Drive <br /> City Manteca <br /> State/Zip California 95336 <br /> Phone 209) 239-4908 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: D Use Permit, [] Major Subdivision, <br /> [� Zone Reclassification, Q Minor Subdivision, D Site Approval, <br /> Zone Variance, LU <br /> X Other: Recreational Vehicle Park <br /> 2. Project location: 1690 West Frewert Road, Lathrop <br /> Describe the project; i .e. , request being made and nature of use. <br /> Identify specific project components : The request is for a 173 R.V. Park <br /> with two mobile home sites, club house, boat dock, boat launcning facilities <br /> permanent restroom, shower, and laundry facilities. <br /> 3 . Total acreage of project: 21.65 # of existing parcels: one <br /> Assessor Parcel # (s ) : 191-270-10 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: None <br /> 5 . Other permits and approvals (County, Regional, State and Federal) <br /> required for this project: <br /> PERMIT AGENCY <br /> Grading Permit Riii l Hi nec, Tnspe—i nn M ui gi nn <br /> River and Levee Worl, Permit TT c rn-nc n- T7QF;ar RPr Dig* 16 <br /> CtatA RLIarnatinn Rnara' RPcinna� 1aater <br /> Well Permit aipljt1, Roard 7J.,;h � C;am- inc—n! F-Taa 1 th <br /> Mobilehome/Recreational <br /> Vehicle Park Permit - 11 - (9/86 ) <br />