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Environmental Information Form <br /> Part B <br /> DATE : July 24, 1989 <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 XXX AGENT OF OWNER <br /> Name San Joaquin County Property Dlanager Nick Isaak <br /> Address 4520 1�. Fight i e Road <br /> Citv Stockton <br /> State/Zip CA 95209 <br /> Phone (209) 953-8800 or 953-8811 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application : XD' Use Permit, Major Subdivision, <br /> Q Zone Reclassification, Q Minor Subdivision, Q Site Approval , <br /> QZone variance, Q Other : <br /> 2 . Project location: 11793 N. Micke Grove Road, Lodi, CA 95240 <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : Requesting approval to construct <br /> and operate an 18 hole regulation length public golf course at Nlicke Grove Park. <br /> 3 . Total acreage of project: 124 1 of existing parcels • two <br /> Assessor Parcel n (s ) : 059-100-02 $ 159-100-03 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date : Negative Declaration, Alicke Grove Golf Course, <br /> notice of determination posted 4/5/88, tate learing House #87111712. <br /> 5 .- Other permits -and approvals (County, Regional , State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> Building Permit County <br /> Use Permit Application - 7 - ( 6/86 ) <br />