Text · page 13 of 18
Read the whole document on one page (all 18 pages, each with its own heading)
This document was a scan. Its text was produced by character recognition and may contain errors; check the original for exact wording.
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 Informatio Name of Action or Project: Additional garage/shed/storage Project Location (describe, and attach a location map): Next to existing two car garage on the property at 296 Fails Rd. Brief Description of Proposed Action: A Adit comm aye a, SHV Name of Applicant or Sponsor: Telephone: (716) 983-1265 John D. Sixt ll E-Mail: [email protected] Address: 296 Fails Rd. City/PO: State: Zip Code: West Falls NY 14170 1. |Does the proposed action only involve the legislative adoption of a plan. local law. ordinance NO YES administrative rule, or reguiation?| If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that Y [] 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 If Yes, list agency(s) name and permit or approval: T] 3. a. (Lotala e of the site of the proposed action 1.25 acres b./Total acreage to be physically disturbe > 2% acres c. [Total acreage (project site and any contiguous properties) owne or controlled by the applicant or project sponsor 1.25 acres 4. Check all land uses that occur on, are adjoining or near the proposed action! [-] Urban [Y Rural (non-agriculture) [1 Industrial [-] Commercial Residential (suburban) [J Forest [[] Agriculture [-] Aquatic [[] Other(Specify): [__] Parkland Page 1 of 3 SEAF 2019