Laserfiche WebLink
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 AGENT OF OWNER <br /> Name 1- R .J ) <br /> Address S i ` e ce EO A )) <br /> City r RGNcrl CArnP <br /> State/Zip ("'-A 9 S,�l 3 i <br /> Phone�') 3') 9 R'2 - 17 L-L, <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q use Permit, N Major Subdivision, <br /> t--! Zone Reclassification, Q Minor Subdivision, EJ Site Approval, <br /> Zone variance, [D Other : <br /> 2 . Project location: g'T ��eeP <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : <br /> 3 '7 Lo? SiDr:fV71L- �'()Ar) ) 1/)Sje <br /> 3 . Total acreage of project: $ . (S # of existing parcels : <br /> Assessor Parcel # (s ) :jG S - i 3 1 - 1 7 C31F q5 70 7 j <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project : <br /> PERMIT AGENCY <br /> Major Subdivision - 7 - (6/86 ) <br />