HomeMy WebLinkAboutEnvironmental Checklist - SEP Application - 8/26/1998 i APR-25-'97 FR I 10:54 I D:HASO I CO TEL 110:. 6�=�-a 7-2425
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A. BACK(7ROUKD i ,
1t Name of proposed project, it applicablee DANL- 96Cx 9(WKKe-AD
I )lase of appliaantt
3.. ' Address i phone number of applicant i contact persons
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0. Date checklist proparode
S. Agency requesting checklists r'(W ,►J CwA4 -RW�&-
6.* Proposed timing or schedule (including phasing, if appiicablo) t
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7. Do you have any plans for future expansionp or further activity
related to or connected with this proposal4 If yes, explain.
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a. List any environmental information you know about that has bwn
prepared, or will be prepared, directly related to this
• proposal.
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g. Do you know whether applications are pending for governmental
approvals of ether proposals directly affecting the property
covered by your proposal? If yea, explain.
10, List any government approvals or permits that will bt needed
for your proposal, if known.
Li. ;i4v:a bri@eo oD- llplets dlr�Iription of your proposal, including
the proposed uses and the size of the project and site. There
are several questions later in this checklist that ask you to
describe certain aspects of your proposal. You do not need to
repeat those answers on this page. (Lead agencies way modify
this form to include additional specific information on project
description. )�..' (lS�'�1(10.�i M 61p
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iZ. What is the 1004tion of tho proposal? [live sufficient
information for a person to understand the precise location of
your proposed project, including a street address, if any, and
seotion, township, and range, if known. If a proposal would
occur over a range of area, provide the rang# or boundaries of
the site(*). Provide a legal description, site plan, vicinity
Map, and topographic sap, if reasonably available. While you
should submit any plans required by the agency, you are not
required to duplicate maps or detailed plans submitted with any
permit applications related to this checklist.
5;
B. LHVIROHHBIi'['AL .RLE![R1(TSs
_. CARTHs
m. 0#neral description of the site (circle oner)i
Flat, rollin hilly, steep slopes, mountainous,
other
b. What is the steepest alope on the site (approuimate
peroent slope)?
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a. What general types of soMgrsvelo
ound an the mite
(for example, a , andpeat, suck)? if
you know the d ficatricultural aoilo,
specify them and not any prime farmland.
d. Are there surface indications or hiotory of
unstable soils in the immediate vicinity? If no,
describe.
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e. Describe the purpose, typo, and approximate
quantities Of any Milling or grading propored.
Indicate source of till.
No -'4I1 .
f. Could erosion occur as a result of clearing,
construction, or use4 If so, generally describe.
g. About what percent of the site will be covered with
Impervious surfaces after project constructions
(for example, asphalt or buildingn)t
h. Proposed seasuree to reduce or control erosion, or
other impacts to the earth, if any. ,
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2. AM
a. What types of emissions to the air would result
from the proposal (i.e. dust, automobile, odors,
Industrial rood smoke) during construction and vhen
the project is completed? If any, generally
desoribe and give approximate quantities, if known.
b. Are there any oft-site sources of emission■ or odor
that may affect your propooal4 If no, generally
describe.
c. Proposed measures to reduce or control emissions or
other impacts to air, it any,
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3. MATER
a• Surfaces
11 Is der+ any surface Rater body on or in the Immediate
vicinity of the site Unoluding year-round and esadonal
stramm'so saltwater, lakeep ponds, wQtlande)4 If yQs, degaribe
type and provide names. If appropriate, state chat stream or
river it flows into.
2) Will the project require any Mork over, in, or adjacent to
(within 200 teet) of the described waterst If yMar, please
desoribe and attach available plans.
3) Estimate the amount of fill and dredge material that would
be placed in or removed from surface water or wetlands and
Indicate the area of the site that would be affected.
Indioatfd the source of fill aaterial.
{) Will the proposal require surface water withdrawals or
diversions! Give general description, purpose, and approximate
quantities if known.
no .
S) Does the proposal lie within a 100-year floodplain? If so,
note locAati�on on the site plan.
6) Does the proposal involve any discharges of waste materiale
to surface waters! If so, dooeribe the typo of want@ and
anticipated volume of discharge.
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be Grounds
1) Will ground water be withdrawn, or will water be discharged
to ground water! Give general description, purpose, and
approximate quantitioat if known.
2) Describe haste material that will be discharged into the
ground from septic tanks or other sources, it any (for example,
Domestic sewages Industrial# containing the general size of
the system, the number of such systems, the number of houses to
be served lit applicable), or the number of animals or humans
the systea(s) are expected to serve.
Now
as eater Runoff (including stars water)
1) Describe the source of runoff (including (storm water) and
method of collection and disposal, if any (include quantities,
if known). Where will this water flow? Will this water flow
into other waterst If so, describer!.
2) Could waste materiale enter ground or surface w4tera? so
generally describe.
d. Proposed measures to reduoa or control surface, ground, and
runoff water impacts, if any)
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4. PLARM
a. Check or circle types of vegetation found an the
with:
deciduous trre t der le, aspen, other
evergreen treat fi , cedar, pins, other
shrubs
grads
pasture
crop or grain
met soil plantst cattail, buttercup, bullrueh, eKunK cabbage,
othora
water plants: water lily, evigraad, miltoil, other
RF'R-25-'97 FR I 10:53 I D:HASOf I CO TEL NO.360-42 7-3425 #335 P03
b. What kind and amount of vegetation will be removed
or altered?
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a. List threatened or endangered species known to ho
on or near the site.
d. Proposed landscaping, use of native plants, or
other meaoures to preserve or enhance vegetation on
the site, if any[
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S. AKINAL8t
a. Circle any 'birds and animals which have been
observed on or near the site or are known to be on
or near the sites
birds: hawk, heron, eagle, songbirds, other
mammals t deer bear, elk, beaver, other _
fish: bass,Qnsloon, trout, herring, mhellfie other _
b. List any threatened or endangered species known to
be on or near the site.
c. Is the site part of a Migration routet If egos
explain.
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d. , Proposed measurer; to preserve- or enhanoo wildlife,
if anys
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6, EKEROY AND NATURAL RE80URCEEs
a. What kinds of energy (eleotrio, natural ges, 'oil,
wood ■tove, solar) will be used to meet the
completed project's energy needs? Describe whether
it will be used for heating, manufacturing, etc.
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b. Mould you project affect the otenti• u
p 1 n of solar
energy by adjacent properties! If so, generally
describe.
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a. What kinds of energy conservation features are
included in the plans of this proposal? Lirt other
proposed measures to reduce or control energy
impacts, if any$
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7. ENVIROKKENTAL HLALTHt
a. Are there any environmental health hazards,
Including exposure to toxic Chemicals, risk of fire
and explosion, spill, or hazardous waste, that
could occur as a reault of this proposal? it ■o,
describe.
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1) describe special emergency services that might
be required.
2) Proposed measures to reduce or control
environmental health hazards, if anyt
b. Noise.
1) What types of nol.ae exists in the area which may
affect your project (for examples traffic,
equipment operation, other)?
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2) What types of levels of noise Mould be created
by or associated with the project on a short-terra
or a long-term basis (for examplet traffic,
construction, operation, other)? Indicato what
hours noise Mould come from the eite.
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3) Proposed Measures to reduce or control noire
impacts, if anyi
8. LAND AND SHORELINE UM
Go, What is the current use of the site and adjacent
properties?
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b. Has the site been used for ogriouiture! If pro,
describe.
a. Describe any structures on the site.
d. Will any structures be demolished? If no, wh*t4
e. What is the current zoning classification of the
■itet
f. What is the current comprehensive plan designation
of the situ
q. If applicable, what is the current sharolino Master
program designation of the site?
h. Has any part of the site been classified as an
•environmentally senuitive' area? If so? specify.
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i. Approximately how many people would reside or work
in the completed project?
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�. Approximately how may pfoplo would the completed
project displace?
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k. proposed measures to avoid or reduce dimpiaoement
impacts# It anyl t, A
1. Proposed measures to ensure the proposal to aarpatible
with existing and projected land uses and plans, if anyl
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�+ HOUSIM
So Approximately how say unite, if any, Mould b•
provided4 Indicate whether high, middle, or low-
income housing.
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b. Approximately how many unitsp if any, would be
eliminated4 Indicate whether highp middlep or low-
income housing. ►
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c. Proposed measures to reduce or Control housing
impacts, if any e
10. AHSTHETIM
a. what is the tallest height of any proposed
structure(s)p not including antennamt what is the
principal exterior building material(d) proposed?
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b. what views in the immediate vicinity would he
altered�or obstruatwd?
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c. Proposed measures to reduce or control aesthetic
impacts, it any:
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1�. LIGHT AND OLAM
a. What type of light or glare will the propoxal
produce? What time of day would it mwinly occur?
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b. Could 11ght or glare from the finished project be a
safety hazard or interior* with vievs4
o. What existing off-site sources of light or glare
may affect your propo■alt
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d. Proposed measures to reduce or control light and
glare impacts, )if any:
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12. RECREATIM
a. What designated and informal recreational
opportunities are in the immediate vicinity?
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b. Mould the proposed project displace any existing
recreational uses! If no, describe.
o. Proposed measures to reduce or control impacts on
recreation, including recreation opportunities to
be provided by the project or applicant, if any:
13. HISTORIC AND CULTURAL PRLSERVATIONs
a. Are there any places or objeute listed on, or
proposed far, national, state, or local
preservation registers known to be on or next to
the site! If so generally describe.
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b. Generally describe any landmark or evidenoe of
historic, archaeological, solentifio, or cultural
importance known to be on or next to the sit*.
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o. Proposed measures to reduce or control impacts, if
any:
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TRAMBPORTATION:
a. Identify public streets and highways serving the Rite and
describe proposed access to the existing Street syeitem.
Show on site piano, if any.
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b. Is site currently served by public transit? If
not, what is the approximate distance to the
existing street cyst&%. Show on site plans, if
any.
o. How many parking spaces would the completed project
haver How many would the project elisinstat
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d. will the require any new roads or streets,proposal
or improvements to existing road@ or streets, not
including driveways? If not generally describe
(indicate whether public or private).
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p, will the project use (or occur in the immediate
vicinity of) water, rail, or air transportation7
If so generally describe.
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_. How many vehicular trips per day would be generated
by the completed pro3eot? If known, indicate when
peak volumes would occur.
g. Proposed measures to reduce or control
transportation impacts, if anya
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is. PUBLIC SEAVICESt
a. Mould the project result in an inareamed nerd for
public service (for examplet fire protection,
polio* protection, health care, sohoolo, other)?
If so generally describe.
b. Proposed measures to reduce or control direct
impacts on public services, if anyt
16. UTILITIESt q4
a. Circle utilities currently available at the mitet
eleatrieity, natural gas, rater, refuse service,
telephone, sanitary sewer, septic system, other.
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b. Describe the utilities that are proposed for the
project, the utility providing the service, and the
general construction activities on the site or in
the immediate vicinity which might be needed.
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17. 916KATURE t
The above answers are true and complete to the best of My
knowledge. I understand that the lead agency is relying on
them to make its decision.
Signature, L L
Date Submitted: 7
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