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d. Other impacts: ______________________________________________________ 9 9 __________________________________________________________________ If any of the above (a-d) are answered “Moderate to large impact may e. occur”, continue with the following questions to help support conclusions in Part 3: i. The proposed action may result in the destruction or alteration of all or part E3e, E3g, 9 9 of the site or property. E3f ii. The proposed action may result in the alteration of the property’s setting or E3e, E3f, 9 9 integrity. E3g, E1a, E1b iii. The proposed action may result in the introduction of visual elements which E3e, E3f, 9 9 are out of character with the site or property, or may alter its setting. E3g, E3h, C2, C3 11. Impact on Open Space and Recreation The proposed action may result in a loss of recreational opportunities or a NO ✔ YES reduction of an open space resource as designated in any adopted municipal open space plan. (See Part 1. C.2.c, E.1.c., E.2.q.) If “Yes”, answer questions a - e. If “No”, go to Section 12. Relevant No, or Moderate Part I small to large Question(s) impact impact may may occur occur a. The proposed action may result in an impairment of natural functions, or “ecosystem D2e, E1b 9 9 services”, provided by an undeveloped area, including but not limited to stormwater E2h, storage, nutrient cycling, wildlife habitat. E2m, E2o, E2n, E2p b. The proposed action may result in the loss of a current or future recreational resource. C2a, E1c, 9 9 C2c, E2q c. The proposed action may eliminate open space or recreational resource in an area C2a, C2c 9 9 with few such resources. E1c, E2q d. The proposed action may result in loss of an area now used informally by the C2c, E1c 9 9 community as an open space resource. e. Other impacts: _____________________________________________________ 9 9 _________________________________________________________________ 12. Impact on Critical Environmental Areas The proposed action may be located within or adjacent to a critical NO ✔ YES environmental area (CEA). (See Part 1. E.3.d) If “Yes”, answer questions a - c. If “No”, go to Section 13. Relevant No, or Moderate Part I small to large Question(s) impact impact may may occur occur a. The proposed action may result in a reduction in the quantity of the resource or E3d 9 9 characteristic which was the basis for designation of the CEA. b. The proposed action may result in a reduction in the quality of the resource or E3d 9 9 characteristic which was the basis for designation of the CEA. c. Other impacts: ______________________________________________________ 9 9 __________________________________________________________________ Page 7 of 10