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Environmental Information Form <br /> Part B <br /> DATE : September 29, 1987 <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 Quartaroli & Associates <br /> Address 160 Northoate Drive <br /> City Manteca <br /> State/Zip CA 95336 <br /> Phone (209) 239-4908 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, Dx Minor Subdivision, Q Site Approval, <br /> Q Zone Variance, E] Other: <br /> 2 . Project location: APN 213-140-4 <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : An approximate 1'/2 parcel is <br /> prnQncari to hp rrPatpd to finance a residence for a member of the owner- <br /> npPratnrc family/ whn Parns a suhstantial portion of their livelihood from <br /> —partiripatinn in npPrating an agriculture enterprise. <br /> 3 . Total acreage of project: 90.17 # of existing parcels : one <br /> Assessor Parcel Us ) :: 213-140-4 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: No <br /> 5 . Other permits and approvals (County, Regional, State and Federal) <br /> required for this project : <br /> PERMIT AGENCY <br /> Percolation Test Permit Local Health District <br /> Well & Septic Permit it 11 11 <br /> Building Permit Building Department <br /> Minor Subdivision - 7 - ( 6/86 ) <br />