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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 <br /> Address_ <br /> City ,C ' <br /> State/Zip C 2 <br /> Phone O <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, Minor Subdivision, Q Site Approval, <br /> Q Zone variance, [] Other : <br /> -Or <br /> 2. Project location: ,t��, Sides- 3 i ���� 2Z, a ���� `• "✓e �� �yln` <br /> Describe the project; i .e . , "reques be4ai-ex <br /> / mane an natur of ase . <br /> Identi y spec f ' project, components : > e CI <br /> 3 . Total acreage of pro',ect: ,�G'Ac, # of existing parcels : <br /> Assessor Parcel # (s ) %DS=Oyu —O 7 <br /> 4 . If there is an existing EIR assess ng any aspect of your project <br /> site, provide title and date : / 7e, <br /> 5 . Other permits and approvals (County, Regional, State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> Use Permit Application - 7 - ( 6/86 ) <br />