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Short Environmental Assessment Form Part 1 - Project Information Instructions for Completing Part 1 – Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1 – Project and Sponsor Information Name of Action or Project: Campground with Wellness Theme and related accessory uses. Project Location (describe, and attach a location map): 1196 Big Tree Road, Town of Aurora, NY (SBL No. 165.00-1-28.21) Brief Description of Proposed Action: Development of Campground with Wellness Theme and related customarily incidental accessory uses consisting of: 1. Sleeping Quarters in 7 seasonal cottages to be constructed; Sleeping Quarters in 2 Treehouse Retreats to be constructed; Sleeping Quarters of 7 sleeping quarters in Sleeping Quarters / Administrative Building (existing building); and 2 sleeping quarters in additional existing building. 2. 2400 feet Lodge to be constructed; 3. Spa / Health Club in existing building;and 4. Related Site Infrastructure including total parking for 61 vehicles in compliance with Aurora Zoning Code. Name of Applicant or Sponsor: Telephone: 716.725.7669 Carner Development Inc. E-Mail: [email protected] Address: 670 Main Street, Suite 2 City/PO: State: Zip Code: East Aurora NY 14052 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, NO YES administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that ✔ may be affected in the municipality and proceed to Part 2. If no, continue to question 2. 2. Does the proposed action require a permit, approval or funding from any other government Agency? NO YES If Yes, list agency(s) name and permit or approval: See attached Exhibit A ✔ 3. a. Total acreage of the site of the proposed action? __________ 83.1 acres b. Total acreage to be physically disturbed? __________ 1.96 acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? __________ 83.1 acres 4. Check all land uses that occur on, are adjoining or near the proposed action: 5. Urban ✔ Rural (non-agriculture) Industrial ✔ Commercial ✔ Residential (suburban) □ Forest ✔ Agriculture Aquatic ✔ Other(Specify): NYS Route 400 / NYS Route 20A □ Parkland Page 1 of 3