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Short Environmental Assessment Form
Part I ~ Project Information
Inséxuctions for Con rr
Part 1 ~ Project Information. The s ppticant or profest
sponsor is responsible for the completion of Part tL, Respon
application for approval or funding, are subject to public ses become part of the
review, and may be subject to further verification. Comple
information currently available. If additional researc te Part 1 based on
h or Investigation would be needed to fully respond to
thoroughly ag possible based on current information, any item, please answer as
’
Complete all items in Part 1, You may also provide any additio
nal information which you believe will be needed by or useful
lead agenoy; attach additional pages as necessary to supple to the
ment any item.
Part I - Project and Sponsor tnformation
Name of Action or Projeot: M 0 V; f- N A) y
Project Location (describe, and attach a rio
. map):
3% Qwood Gy e
Brief Description df Proposed Actlon:
Name of Applicant or Sponsor:
Telephone
Lackawente thu Site Deselopmert Lorpordion E-Mail: Qc Ie jew 5 EAL,
bo bi,foal
City/PO: ; UG _
en !. Does Lac hayatle
the proposed action only involve
State:
VY
Zip Code:
aks
the legislative adoption ofa pian, locat law, ordinance,
aditlnistrative rue, or regutation? NO | YRS
If Yes, attach a narrative desor ption of the intent of the propose
may be affected in the municipality and proceed fo Part d action and the environmental resources that 4
2. [fno, continue to question 2. [|
2, Doss the praposed action require a permit, approva
l or finding from any other government Agency?
If Yes, list ager ey me and perinit or approva NO YES
l: ,
New Vor 2 Homes ald Community
|
fenent
3, a, Total acreage of the site of the proposed notion
? Lt |
b, Total acreage to be physically disturbed? * acres
_ a! actos
¢. Total acreage (project site aud any contiguous
propertles) owned
or controlled by the applicant or project spons
or? . f ATES
4, Cheek all tand uses that occur on, are adjoining
or nm ear the proposed action;
5. [7] Urban (J Raval Cnon-agriculture) {7] Industrial [1 Commercial wf Restdeatia (suburban)
CT Povast [7] Agriculture [JA quatic [1] Other(Specify):
T"] Parkland
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_ SEAF 2019