HomeMy WebLinkAbout20211120 69 Caroline Use Variance EAF I 8.Does the proposed action include construction or other activities that result in the impoundment of N ES
water or other liyuids(e.g.retention pond,waste lagoon,dam)'?
if Yes,explain purpose and size:
19.Has the site of the proposed action or an adjoining property been the loc ' n of an active or closed NO YES
solid waste management facility?
lf Yes,describe:
20.Has the site of'the proposed action or an 'oining property been the subject of remediation(ongoing or NO YES
complctcd)for hazardous waste?
If Yes,describe:
1 AP'FIIiM THA E INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KN[)N'LF;D ,
Applic sponsor name: Date:
Si ature:
Part 2-Impact Assessment. 7'he Lerd Agency is responsible for the cumpletion of Part 2. Answer all of thc following
qucstions in Part 2 using thc infomiation containcd in Part I and othcr ntatcrials submittcd by thc projcct sponsor or
othenvisc available to the reviewer. When answering the questions the reviewer should bc guided by the concept"Have my
responses been reasonable considering the scale and context of Ihe proposed action7"
No,or Moderate
small to large
impact impact
may may
occur uccm-
I. W ill the proposed action create a material conflict with an adoptcd land use plan or zonittg
regulations'?
2. Will the proposed action result in a change in the use or intensity of use of land?
3. W ill thc proposed�ction impair the character or qtiality of the existing community?
4. Will the proposed action have an impact on the environmental characteristics that caused the
establishment of a Critical Environmental Area(CEA)'?
5. Will the proposed action result in an adverse change in the existing level oFtrallic or
affect existing infrastnicture for mass transit,biking or walkway'?
6. Will Ihe Proposed action cause an increase in the use of energy and it fails ro incorporate
reasonablv available ener conservation or renewable ener o ortunities'?
7. Will the propused actinn impact existing:
a.public/private water supplics'?
b.public/private wastewater treatment utilities'?
R. Will tl�e proposed action impair the character or quality of important hisroric,archaeological,
architcctural or aesthetic resources'?
9. W'ill the proposed action result in an adverse change to natural resources(e.g.,wetlands,
waterbodies,groundwater,air quality,flora and fauna)'?
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No,or Moderate
smail to largc
impact impact
maV may
occu occur
10. Will the proposed action resuit in an increase in the potential for erosion,flooding or drainage
problcros?
I I. Will ihe proposed action create a hazard to environmental resources or human health'?
Part 3-Defermination of significance. The Lead Agency is responsible for the cumpletion of Part 3. For evcry
question in Part 2 lhul w•as ans�vcrcd"moderx[e to large impxct may uccur",or if therc is a necd to explain why a particular
element of the proposcd action may or will not result in a significant adverse environmental impact,please complete Pait 3.
Pait 3 should,in sufticient detail,identify the impact,including any mcasures or design elemcnts that have been included by
the project sponsor to avoid or reduce impacts. Part 3 should altio expiain how the lead agency determined that the impact
nn�y or will not be signiticant.Each potential impact shuuld be assessed considering its setting,probability of occutTing,
duration,irrcvcrsibility,gcographic scope and mngnitudc. nlso considcr thc potcntial for short-tcrm,long-tcrm and
cmnulative impacts.
❑ Check this box iY you have determined,based oi�the infonnation and analysis�bove,and any supporting docwnentation,
that the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
❑ Check tl�is box if you have detennined,based on the infomiation and�nalysis above,and any supporting documentation,
that the proposed actiun will not result in any signiticant adveise environmental impacts.
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Name of Lead Agency � Date
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Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
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Signature of Responsible Officer in l.ead Agency Signature of Preparer(if different from Responsible Officer)
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