Text · page 101 of 104
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5. Is the proposed action, NO YES NIA
a. A permitted use under the zoning regulations? ;,,--
□ ~ i"'
b. Consistent with the adopted_ comprehensive plan? □ 5{ t_~
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6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES--
landscape?
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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:
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8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO . YES
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b. Al·e public transportation service{s) available at or near the site of the.proposed action?
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c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed actio~ fi{]
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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;
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10. Will the proposed action connect to an existing public/private water supply? NO YES
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If No, describe method for providing potable water: ff( □
11. Will the proposed action connect to existing wastewater utilities? NO YES
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If No, describe method for providing wastewater treatment:
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12. a. Does the site contain a structure that is listed on either the State or National Register ofHistoric NO YES
Places?
b. Is the proposed action located in an archeological sensitive area?
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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? I~- □
h. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody?
If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: E ~□
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14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply:
D Shoreline □Forest ~ .·cultural/grasslands □Early mid-successional
D Wetland D 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 locate1 in the 100 year flood plain?
'CB □
~o ......'l:ES
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17. Will. the proposed actionl reate storm water discharge, either from point or non-point sources? NO) YES
IfYes,
a. Will storm water disch ges flow to adjacent properties?
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f:.tl,NO DYES Q □
b. Will storm water disch, rges be directed to established conveyance systems mnoff and storm drains)?
If Yes, briefly describe: NO □YES
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