Text · page 26 of 27
Read the whole document on one page (all 27 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.
14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply:
CShoreline [[] Forest [[] Agricultural/grasslands [CJ Early mid-successional
Clwetland [TJ Urban Suburban
15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or
)} 1/3) 8 z°o
Federal government as threatened or endangered?
16. Is the project site located in the 100-year fload plan?
SS
17. Will the proposed action create, storm water discharge, either from point or non-point sources?
If Yes,
a, Will storm water discharges flow to adjacent properties?
b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)?
If Yes, briefly describe:
18. Docs the proposed action include construction or other activities that would result in the impoundment of water
or other liquids (¢.g., retention pond, waste lagoon, dam)?
If Yes, explain the purpose and size of the impoundment:
19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste | NO | YES
management facility?
Tf Yes, describe:
[¥})
20,Has the site of the proposed action or an adjoining property been the subject of yemediation {ongoing or NO | YES
completed) for hazardous waste?
If Yes, describe:
1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE ES TRUE AND ACCURATE TO THE BEST OF
MY KNOWLEDGE
Applicant/sponsor/name;_ Timothy Michaels Date; 3/16/2026
Signature: 3 maotly P Wy ehyraty Title: Mayor
PRINT FORM Page 3 of 3