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! "5. Is the proposed action, NO YES | N/A
a. A permitted use under the zoning regulations? ><
b. Consistent with the adopted comprehensive plan?
6. Is the proposed action consistent with the predominant character of the existing built or natural NO _ | YES
landscape?
7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? NO | YES
If Yes, identify: x
8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO | YES
b. Are public transportation service(s) available at or near the site of the proposed action? s
c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? a
9. Does the proposed action meet or exceed the state energy code requirements? NO | YES
If the proposed action will exceed requirements, describe design features and technologies:
10. Will the proposed action connect to an existing public/private water supply? NO | YES
[If Yes, does the existing system have capacity to provide service? (BNO O YES]
If No, describe method for providing potable water: x
11. Will the proposed action connect to existing wastewater utilities? NO | YES
{If Yes, does the existing system have capacity to provide service? PX NO C1 YES]
If No, describe method for providing wastewater treatment:
12. a. Does the site contain a structure that is listed on either the State or National Register of Historic NO | YES
Places? 4
b. Is the proposed action located in an archeological sensitive area? XS
13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain NO | YES
wetlands or other waterbodies regulated by a federal, state or local agency? *’
b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody? > 4
If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres:
14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply:
CQ Shoreline M Forest C1 Agricultural/grasslands Cl Early mid-successional
C1 Wetland (J Urban && Suburban
15. Does the site of the proposed action contain any species of animal, or associated habitats, listed NO |; YES
by the State or Federal government as threatened or endangered? >
16. Is the project site located in the 100 year flood plain? NO | YES
17. Will the proposed action create storm water discharge, either from point or non-point sources? NO_ | YES
If Yes,
a. Will storm water discharges flow to adjacent properties? f4 NOYES
*
b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)?
If Yes, briefly describe: ' C] NO 8 YES
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