HomeMy WebLinkAbout2024-3-28 975 Anderson Hill Road Full Environmental Assessment Form & MapperPage 1 of 13
Full Environmental Assessment Form
Part 1 - Project and Setting
Instructions for Completing Part 1
Part 1 is to be completed by the applicant or project sponsor. Responses become part of the application for approval or funding,
are subject to public review, and may be subject to further verification.
Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to
any item, please answer as thoroughly as possible based on current information; indicate whether missing information does not exist,
or is not reasonably available to the sponsor; and, when possible, generally describe work or studies which would be necessary to
update or fully develop that information.
Applicants/sponsors must complete all items in Sections A & B. In Sections C, D & E, most items contain an initial question that
must be answered either “Yes” or “No”. If the answer to the initial question is “Yes”, complete the sub-questions that follow. If the
answer to the initial question is “No”, proceed to the next question. Section F allows the project sponsor to identify and attach any
additional information. Section G requires the name and signature of the project sponsor to verify that the information
contained in Part 1is accurate and complete.
A. Project and Sponsor Information.
Name of Action or Project:
Project Location (describe, and attach a general location map):
Brief Description of Proposed Action (include purpose or need):
Name of Applicant/Sponsor: Telephone:
E-Mail:
Address:
City/PO: State: Zip Code:
Project Contact (if not same as sponsor; give name and title/role): Telephone:
E-Mail:
Address:
City/PO: State: Zip Code:
Property Owner (if not same as sponsor): Telephone:
E-Mail:
Address:
City/PO: State: Zip Code: