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 Baumbach f, Piazza, Inc. <br /> Address 323 Nest Elm Street <br /> City Lodi <br /> State/Zip CA 9S240 <br /> Phone368-6618 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, Q Major Subdivision, <br /> �] Zone Reclassification, Q Minor Subdivision, Q Site Approval , <br /> Zone variance, Q Other : <br /> 2 . Project location: East side of Hillside Drive, 1/2 mile South of Brandt Drive <br /> Describe the project; i.e . , request being made and nature of use . <br /> Identify specific project components : Create neu, parcel for residential/ <br /> agriculture purposes. <br /> 3 . Total acreage of project: 25.2 + Ac # of existing parcels: 1 <br /> Assessor Parcel # (s ) : 053-770-77- <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: NONE <br /> PERMIT AGENCY <br /> Minor Subdivision - 7 - ( 6/86 ) <br />