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Environmental Information Form <br /> Part B <br /> DATE: DEC. 29) 14 87 <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 WONCr EOGIOEEIZ9 3 INC. <br /> Address ¢ST$ FEATHEI- Iz►VER- D91VE _ SUITE A <br /> City STo CV-TON <br /> State/Zip CA 451Z01 <br /> Phone 4-"7C-00 11 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, r'�71 Minor Subdivision, Q Site Approval, <br /> QZone variance, Q Other: <br /> 2. Project location: BETWEEN Al.10E ST. Fr- WlNQSO1` AVE . <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : <br /> 3 . Total acreage of project: 0.19 # of existing parcels : <br /> Assessor Parcel Us ) :: 1¢3 — 4-10 — 11 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site, provide title and date: NO N F- <br /> 5. Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> N0N E <br /> Minor Subdivision - 7 - ( 6/86 ) <br />