Laserfiche WebLink
Environmental Information Form <br /> Part B <br /> DATE: Selet ID- Ia? 7 <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 c <br /> Address 2 ; IL PrL <br /> City <br /> State/Zip ' <br /> Phone <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, R Minor Subdivision, E] Site Approval , <br /> QZone variance, Q Other: <br /> 2. Project location: IalII q- , !9135 <br /> Describe the project; i .e. , request being made and nature of used-S 3 <br /> Identify specific project components :--"Q2ff _d ��� ��' �:• <br /> — ,TT <br /> GC- LJ-U S i n I G m:I 4-o Y c- <br /> it1 n,.CIr00,A.. �, A' iwYe 4.. d wi i1 be-. 1.�.5Qd ac �,Jrh fi'hQ dt. Ih <br /> 'i <br /> 3 . Total acreage of project: �5� # of existing parcels : <br /> Assessor Parcel Us ) :: t29 - .270 - a., <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 /> Minor Subdivision - 7 - ( 6/86 ) <br /> �I <br /> I <br />