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Home My WebLink About1000-103.-9-3~ON °~~ o~ ~o ..,. tVE EX R,= 5,0 , PLANNING ~'OWN OF NOTE: · = MONUMENT · NOTES: L TOTAL ASEA = 81,047 2. SUFFOLK CO, TAX MAP DIST I~$ECTJo~ BL.OO~g LO"EOO~ & o02 RECEIVED BY OOlITNO[D TOWN PL~N~INO BOARO JUN 1 8 198~ DATE MINOR SUBDIVISION AUGUST BOHN & RUTH BOHN EAST CUTCHOGUE TOWN OF SOUTHOLD SUFF. CO., N,Y. SCALE= I" =50' MARCH ~6~1985 JUNE 1~,1985 YOU PROF N0.85-~61 Southold, N.Y. 11971 (516) 765-1938 January 14, 1986 Abigail Wickham Wickham, wickham, and Bressler Attorney at Law P.O. Box 1424 Mattituck, NY 11952 Re: Set-off for Ruth and August Bohn Dear Mrs. Wickham: The following action was taken by the Southold Town Planning Board, Monday, January 13, 1986. RESOLVED that the Southold Town Planning Board approve the set-off for Ruth and August Bohn located at Beebe Drive, Cutchogue; survey dated as amended June 12, 1985. It was noted that this proposal received Article 6 approval from the Suffolk County Health Department, and a variance on the insufficient areas from the Board of Appeals. When the Chairman has endorsed the surveys, we will forward one to you. If you have any questions, please don't hesitate to contact our office. Very truly yours, BENNETT ORLOWSKI, JR., CHAIRMA~' C~ SOUTHOLD TOWN PLANNING BOARD By Diane M.Schultze, Secretary cc: Ruth and August Bohn TO~N CLERK TOWN OF SOUTHOLD Suffolk County, New York 516 - 765-1801 N.° ~ 159§~' RECEIVED O~ ,~" Judilh T. Terry, Town Clerk P E .A.)N N I NGT'B~,~ O T0,W:N OF sOU~HOLD 8outhold, N.Y. 11071 (516) 765-1938 January 21, 1986 Mrs. Abigail Wickham Wickham, Wickham, and Bressler Attorney at Law P.O. Box 1424 Mattituck, NY 11952 Re: Set-off for Ruth and August Bohn Dear Mrs. Wickham: Enclosed is a signed survey for the above mentioned proposal which has been approved by the Planning Board. If you have any questions, contact our office. enc. please don't hesitate to Very truly yours, BENNETT ORLOWSKI, JR. , CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Diane M. Schultze, Secretary cc: Ruth and August Bohn with enc. COUNTY OF SUFFOLK Robert J. Gaffney SUFFOLK COUNTY EXECUTIVE Copy DEPARTMENT OFHEALTHSERVICES September 28, 2001 CLARE B. BRADLEY, M.D., M.P.H. Commissioner Mr. and Mrs. D. Ryan 70 Jackson Place Massapequa, NY 11758 Subject: Board of Review Screening - August 14, 2001 Report of Findings and Recommendations of the Review Board Regarding: RI0-00-0040 - Residence for Douglas and Carol Ryan, w/s/o Beebe Drive Extension, 108 ft. s/o Wilson Avenue, Cutchogue - tJo Southold - SCTM: #1000-103-9-2 Dear Mr. and Mrs. Ryan: Enclosed is a copy of the Board ofReview's findings, recommendations and determination concerning the subject application. Based on the information submitted, the Board granted the request for variance with the provisions indicated in the determination. The granting of this waiver does not imply that your application will be automatically approved. It is your responsibility to ensure that your application is complete; otherwise, your approval will be subject to unnecessary delay. Very truly yours, Walter Dawydiak, P.E., J.D. Acting Chairman, Board of Review enclosure. cc: Board of Review - Riverhead James Bagg - Planning Dpt. Valerie Scopaz - Town of Southold Patricia Moore, Esq. Mr. and Mrs. Menendez Douglas Feldman, PE - SCDHS SC DEPT HEALTH SERVICES BOARD OF REVIEW ~ 220 RABRO DRIVE EAST ~ HAUPPAUGE, NY 11788-4290 (631) 853-3084 ~ Fax (631) 853-3075 To: Subject: Article 2, Section 220, Suffolk County Sanitary Code Clare B. Bradley, M.D., M.P.H. Commissioner of Health Services Walter Dawydiak, P.E., J.D., Acting Chairman, Board of Review Report of Findings and Recommendations of the Review Board Regarding: Rl i:-OO'oO40- Residence for Dougias and Carol Ryan, w/s/o Beebe Drive Extension, ft. s/o Wilson Avenue, Cntchogue _ t/o Southold _ SCTM: #1000-103-9.2 Douglas and Carol Ann Ryan 70 Jackson Place Massapequa, NY 11758 Notice ofHearin : Screening Statement of Problem ~ August 14, 2001 Construct/on standards require that the distance between sanitary systems and shallow private wells be least 150 feet (ft.). The applicant is proposing installing the sanitary system less than 150 ft. from a private well. I. Proposed development ora Single-family residence on a 39,146 sq 2. Site is in Gr°undwater Management Zone #IV. ' ft. Parcel. 3. Area is Zoned residential. 4. Public Water is available. 5. Depth to groundwater is approximately 6 ft. 6. Soils are coarse sand at 2 ft. 7. Groundwater flow is to the southwest. 8. The applicant seeks a variance from sanitary system setbacks, which is proposed as 102 9. private well to the east (hereinafter the "Menendez property"), ft. from a A report by applicant's Professional Engineer, Michael Mapes, indicates that groundwater flow will not preSeDeterminationnt a risk of contaminating the well on the Menendez property. It was a 3 to 0 determination of the Board of Review to grant the request for Variance. Given the :ue~sa[:ntil7~ dai;t.~ ;rnsC:;anffcdcJ. he direction of groundwater flow, approval of this project will not have any Walter Dawydiak, p.E.~, ;.D., Actina Board of Review ~ '~,,u~rman at SUFFOLK ~IJUNTY DEPARTMENT OF O HEALTH SEKrViCES DIVISION OF ENVIRONMENTAL QUALITY Article 2, Section 220, Suffolk County Sanitary Code To: Clare B. Bradley, M.D., M.P.H. Commissioner of Health Services From: Walter Dawydiak, P.E., J.D., Acting Chairman, Board of Review Subject: Report of Findings and Recommendations of the Review Board Regarding: RI 0-00-0040 - Residence for Douglas and Carol Ryan, w/s/o Beebe Drive Extension, 108 ft. s/o Wilson Avenue, Cutchogue - t/o Southold - SCTM: #1000-103~9-2 ~: Douglas and Carol Ann Ryan 70 Jackson Place Massapequa, NY 11758 Notice of Hearin__g~.- Screening Screeni~ August 14, 2001 Statement of Problem Construction standards require that the distance between sanitary systems and shallow private wells be at least 150 feet (ft.). The applicant is proposing installing the sanitary system less than 150 ft. from a private well. Findin~ 1. Pr°p°sed devel°pment °f a single-family residence on a 39,146 sq. ft. parcel. 2. Site is in Groundwater Management Zone #IV. 3. Area is Zoned residential. 4. Public Water is available. 5. Depth to groundwater is approximately 6 ft. 6. Soils are Coarse sand at 2 ft. 7. Groundwater flow is to the southwest. 8. Th.e applicant seeks a variance from sanitary system setbacks, which is proposed as 102 ft. from private well to the east (hereinafter the "Menendez property"), a 9. A rep°rt bY applicant's Professional Engineer, Michael Mapes, indicates that groundwater flow will not present a risk of contaminating the well on the Menendez property. Determination It was a 3 to 0 determination of the Board of Review to grant the request for variance. Given the Separation distance, and the direction of groundwater flow, approval of this project will not have any substantial adverse effect. Walter Dawydiak, p.E.~an- Board of Review OEC 1 1985 Southold Town Board of Appeals MAIN ROAD- STATE ROAD 25 ISOUTHOLD, L.I., N.Y. 119'71 TELEPHONE (516) 765-1809 ACTION OF THE ZONING BOARD OF APPEALS Appeal No. 3373 Application Dated June 7, ]985 TO: Mrs. Ruth B0hn P.O. Box 453 Beebe Drive Cutchogue, NY 11935 [Appellant(s)] At a Meeting of the Zoning Board of Appeals held on December ]2, ]985, the above appeal was considered, and the action indicated below was taken on your [ ] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article , Section [×] Request for Variance to the Zoning Ordinance Article III, Section 100-3l, Bulk Schedule [ ] Request for Application of RUTH BOHN - Appeal No. 3373 - Variance to the Zoning Ordinance, Article III, Section 100-31, Bulk Schedule, for approval of insufficient lot area and width (frontage) of two parcels located at the west s'ide of Beebe Drive, Cutchogue, NY; County Tax Map District 1000, Section 103, Block 9, Lots 2 and 3. WHEREAS, a public hearing was held and concluded on November 14, 1985 concerning the Matter of the Application of RUTH BOHN under Appeal No 3373; and .. WHEREAS, the board has considered all testimony and documentation entered into the record concerning this application, and it is noted for the record that no public opposition has been received; and WHEREAS, the board members have personally viewed and are familiar with the premises in question as well as its surrounding area; and WHEREAS, the board made the following findings of fact: 1. The property in question is located in the Residential and Agricultural Zoning District, situated at the southerly end of Beebe Drive, Cutchogue, and is more particularly identified on the Suffolk County Tax Maps as District lO00, Section 103, Block 9, Lots 2 and 3. 2. The subject premises as a whole consists of a total area of 81,047 sq. ft., frontage (lot width) of 274.05 feet along Beebe Drive, and average lot depth of 377.73 feet to the highwater mark as shown on survey dated June 12, 1985 prepared by Alden W. Young, L.S. 3. By this application, appellant proposes two lots in this pending set-off division of land, to wit: (a) Parcel #1 of 41,900 sq. ft. and lot width of 100 feet at the dwelling setback line, and (b) Parcel #2 of 39,147 sq. ft. and lot width of 103± feet at the required building setback line (167.35 feet along Beebe Drive). CONTINUED ON PAGE TWO) DATED: December 18, 1985. Form ZB4 (rev._ 12/81) CHAIRMAN, SOUTHOLD TOWN OF APPEALS ZONING BOARD Page 2 -- Appeal No. 3373 Matter of RUTH BOHN Decision Rendered December 12, 1985 4. Proposed Parcel #2 is vacant; proposed Parcel #1 is improved with a single-family, two-story frame house with attached garage set back 41.5' from its nearest point from the front property line, and an accessory inground swimmingpool structure and 16.2' by 16.3' framed accessory building, both located in the required rearyard area. 5. In researching the history of this property, town records show that the property was purchased at two separate times and deeds, Lot #1 on June 5, 1967 at Liber 6163, cp 474, and Lot #2 on April 29, 1967. It is also noted that the Suffolk County Department of Health Services by letter dated June 14, 1985 is not requiring Article 6 approval and recognizes the parcels as shown on the 1980 County Tax Map as two lots, and permit dated November 22, 1985, approval has been received from the N.Y.S. Department of Environ- mental Conservation pursuant to Article 25 of the Tidal Wetlands Act. 6. ]n viewing the immediate area, it is also noted that the lots as proposed by this application are consistent with the size of those lots generally existing to the north and northeast of the subject premises which are smaller. In considering this appeal, the board finds: (a) that the relief as requested is consistent with a majority of other lots iq the area and therefore will not be a substantial change in the character of the district; (b) that the circumstances of this al)peal are unique as noted above; (c) that by allowing the variance, no substantial detriment would be created affecting adjoining properties, (d) that no adverse effects will be produced on available governmental facilities of any increased population; (e) that the variance will be in harmony with and promote the general purposes of zoning; (f) that the interests of jus%ice will be served by allowing the variance, as indicated below. Accordingly, on motion by Mr. Sawicki, seconded by Mr. Grigonis~ it was RESOLVED~ that the relief requested under Appeal No. 3373 'in the Matter of the Application of RUTH 80HN for insufficient lot area of Parcel #1 of 41,900 sq. ft. and frontage along Beebe Drive Extension of 135.48 feet, and insufficient lot area of Parcel #2 of 39,147 sq. ft. and frontage along Beebe Drive Exten- sion of 167.35 feet, BE AND HEREBY IS APPROVED SUBJECT TO THE FOLLOWING CONDITIONS: There be no further lot area or frontage reductions; 2. The lowest habitable dwelling structure upon Parcel elevation above mean sea level "A-4" Flood Zone. floor(or foundation floor with utilities) in a #2 shall be at the minimum flood of 8 feet when.located in the Vote of the Board: Ayes: Messrs. Grigonis, Sawicki and Dougiass~ (Chairman Goehringer abstained from vote~ Member Doyen of Fishers Island was absent due to illness.) This resolution was adopted with a vote of three of the four members present. · GOEHR'INGER, C~AIRMAN December 18, 1985 PETER F. COHALAN SUFFOLK COUNTY EXECUTIVE JUL 111985 DEPARTMENTOFHEALTH SERVICES ~,~ TO: Ruth and August Bohn Box 453 Cutchogue, N.Y. 11935 RE: Bohn (T) Southold Dear Mr. and Mrs. Bohn: I am in receipt of your applicati'on for approval of the above referenced real~y development. This'is to confirm that approval to this Department for a realty development is not required at the present time. This Department is using the 1980 tax maps as a guide in determin- ing whether or not the filing of a realty development map is required under Article 6 of the Suffolk County Sanitary Code. Since it appears that the number of tax parcels have not increased since 1980, this Department is not requiring the filing of a realty development map. It should be noted that, the policy of this Department's use of the tax maps as a guideline is under review by the County Attorney's office and therefore subject to change in the future. If you have any questions concerning this, please feel free to contact me. Very truly yours, Royal R. Reynolds, P.E. Public Health Engineer Waste Water Management Section RRR:lJr 548-3318 S ;OLK COU Y DEPARmENT OF .EALT RVICES WASTE WATER MANAGEMENT SECTION Suffolk County Center Riverhead, New York llgO1 NOTICE OF INCOMPLETE APPLICATION - SUBDIVISION Your preliminary/final plan submission for the above referenced subdivision or develop~? has been reviewed by this office. To meet the requirements of this Department, and prto~O any final review of your proposal as submitted, this office will require the following: Preliminary Submission r) Slgned Appl I cations ~3 Realty Subdivision or Development Application HRS-1. m Environmental Assessment Form. ~ ~paper prints of proposed subdivision or development plan, including topographi~i' survey. ~ Test Holes [] Located and witnessed by representative of this office. Call 548-3321 for appotnt~t. ~ Licensed~surveyor pr engineer as per SCDHS location instructions. [] Other ~ ~th ~ _Test Well * . ~m Located and sampled by a representative of this off~ce. ~95 for appoln~t~m~,t. by an approved laborat y. . · Other O~ ~ (~ - []Public Water Availability Letter from Local Water District Final Submission ~Include on Final Maps Test hole locations/details Test well locations/details Sewer line locations/details Sewage Disposal L. ocation~ Water main locat~ons/detai?§ Professional engineer's signature and "statement". O_~ther LIThe following are required prior to continuing review: ~ Board of Review determination letter. ~ Wetlands permit or determination letter from NYSDEC. ~ SEQRA determination letter from Town/State. / ~ Filing fee check of $4.50 per lot at time of submission. Requirements ADDITIONAL INFORMATION MAY BE REQUIRED PRIOR TO FINAL APPROVAL. OF THIS FORM WITH ANY RESUBMISSION. PLEASE RETURIi. A COPY p ~ D Southold, N.Y. 11971 (516) 765-1938 June 26, 1985 Ms.Abigail wickham wlckham, wickham, and Bressler P.O. Box 1424 Mattituck, NY 11952 Re: Set-off for Ruth Bohn and August Bohn Dear Ms. wickham: The Planning Board reviewed the above mentioned application at the regular meeting of June 24, 1985. It was the consensus of the Board to hol~ this application in abeyance pending action by the Board of Appeals regarding the insufficient area and width variances. If you have any questions, please don't hesitate to contact our office. Very truly yours, $OUTHOLD TOWN PLANNING BOARD By Diane M. schultze , Secretary cc: Board of Appeals p ~ 50 R~c , NOTES: I TOTAL AREA= 2. SUFFOLK CO "f DIST Io6)SECT Lo_; MINOR SUBDIVISION AUGUST BOHN & F EAST CUTCHOGL TOWN OF SOOT SUFF. CO., N.Y. SCALE: I" = 50' MARCH 26,1985 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated .. ~.... ~ ............ 19 .?~.'~. House No. Street Hamlet County Tax Map No. 1000 Section .............. Block .............. Lot ............... Subdivision .... /. ?..~. ........ Filed Map No ........ .~. ....... Lot No .... .~ ............ is returned herewith and disapproved on the following grounds.....~...'..c~.:, .~'.. Building Inspector RV 1/80 Southold Town Planning Board Town Hall Southold, New York 11971 Gentlemen: Re: (1) No grading, other than foundation excavation for a residential building is proposed. (2) No new roads are proposed and no changes will be made in the grades of the existing roads. (3) No new drainage structures or alteration of existing structures are proposed. Yours truly, The following statements are offered for your consideration in the review of the above-mentioned minor subdivision and its referral to the Suffolk County Planning Commission: APPLICATION FOR APPROVAL OF PLAT To the Planning Board of the Toxvn of Southold: The undersigned applicant hereby applies for (tentative) (final) approval of a subdivision plat in accordance with Article 16 of the Town Law and the Rules and Regulations of the Sou(hold Towu Planning Board, and represents and states as follo~vs: 1. The applicant is the owner of record of the land under application. (If the applicant is not the owner of record of the land under application, the applicant shall state his interest in said land under application.) 3. The entire land under app!ication is described in Schedule "A" hereto annexed. (Copy of deed suggested.) The land is held by the applicant under deeds recorded in Suffolk Count)' Clerk's office as follows: Liber .... t;. 1. k .5 ............ Page ..... .~.-1.~i ........... On . Liber .... ~i..L.%.:c5 ........ Page ..... LL.~:(c. .......... On 91~'~ ? ..1).~.~ .... ; Liber ........................ Page ...................... On ....................... ; Liber ........................ Page ...................... On ....................... Liber ...................... ,. Page ...................... On ....................... as devised under the Last 'vVill and Testament of ....................................... distributee .................... . ............. or as 6. All taxes which are liens on the land at the (late l~ereof have been paid except ...~d.. fl. ...... 7. The land is encumbered by ...[.~-Et¥¢: ....... .o.r. o.~.e ..................................... mortgage (s) as follows: (a) Mortgage recorded in Liber .............. Page .................. in original ammmt of $ .............. unpaid amount $ ..................... held by . .L..ohls~:....~..a..c,]~... .............. aadress .$.~..~.g ¢.¢....A?..~.,...td.~.s)..t,.~..~.~,)..ca.../~.e~/~.... 1 .~.~/ .......... (b) Mortgage recorded in Liber ......... Page ....................... in original amonnt of .............. unpaid amount $ ...................... held hy ...................... .............. address ............................................................... (c) Mortgage recorded in Liber .............. Page ................ in original amount o£ .............. unpaid amount $ ...................... held by ...................... ...................... address ......................................................... 8. There are no other encumbrances or liens against the land except .l~..~.. 9. The land lles in the following zoning use districts .... ..~-..~.~.-54~.e..~J.l~l ................ 10. 11. 12. No part of the land lies under water whether tide water, stream, pond water or otherwise, ex- cept .. 0-~ O~ ½ e~. . . . .O. .r[ .... .t~..o.~. ............................................ The applicant shall at his exl~ense install all required public improvements. The land Ota~s) (does not) lie in a Water District or Water Supply District. Name o£ Dis- trlct, if xvithin a District, is ..... ..................................................... 13. Water mains xvill be laid by i..(54...~. ..................................................... and (a) (no) charge will be made for installing said mains. 14. Electric lines and standards xvill be installed by /-. /k (~ .................................. . .. and (a) (no) charge will be made for installing said lines. 15. Gas mains xvilI be installed by .... ~./.~...:.. -- '- " and (a) (no) charge will be made for installing said mains. 16. If streets shown on the plat are claimed by the applicant to be ex stin,, nub c streets in the Suffolk County Highway system, annex Schedule "B" hereto, to show same. 17. If streets shown on the plat are claimed by the applicant to be existing poblic streets in the Town of Southold I-Iighway system, annex Schedule "C" hereto to show same. ~4, eJoe 13rt&. ['~ 18. There are no existing buildlu~,s or structures on the land wblcb are not located and shown on the plat. 19. Where the plat shows proposed streets which are extensions of streets on adjohfing sub- division maps heretofore filed, there are no reserve strips at the end of the streets on said existing maps at their conjunctioos with the proposed streets. 20. 21. In the course of these proceedings, the al~plicant will offer proof of title as required by Sec. 335 of the RcaI Property Law. Submit a cop3' of proposed deed for lots showing all restrictions, covenants, ~2tc. Annex Schedule "D". 22. The applicant estimates that the cost of gradiug and reqnired public improvements xvill be $ .......... as itemized in Schedule 'E' hereto annexed and reqnests that the maturity of the Performance Bond be fixed at '. ............. years. The Performance Boud will be written by a licensed surety company unless otbe.rwise shown on Schedule "F". (Name of Applicant) (Signature and Title) · ...... ....... (Address) STATE OF NEW YORK, COUNTY OF ..... .~.~[ ;[0 .~. ................. ss: On the .... .q..~.. ........ day o~.........75 (x fl. ~.-................., 19.~.~'2 ., before ,ne personally came ...15.~.~.[.! ....~... J~.(;'.l:4.~bI ............ to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that . .S.I~ .~ ..... executed the same. Notary Public STATE OF NEW YORK, COUNTY OF ............................ ss: On the ................ day ............ of ................ 19 ....... before me personally came ........................ '.. t6"h,e known, who being by me duly sworn dld de- pose and say that ............ resides at No ..................................................... ................................. that .......................... is the .......... the corporation described in and xvbich executed the foregoin~ instrument; that ............ knows the seal of said corporatlon; that the seal affixed hy order of the board of directors of said corporation. ~m,I that ............ signed .............. name thereto by like order. Notary Public 14-16-4 (9/84) · IPROIECT I.D. NUMBER NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DIVISION OF REGULATORY AFFAIRS State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I Project Information (To be completed by Applicant or Project sponsor) 2. Project Name 3. Project location: 4. Is propo~ed action: [~New [] Expansion [] Modification/alteration 5. Describe project briefly: 6 Precise J~at~on (road intersections, prominent landmarks, etc. or provide map) 7. Amount of land affected: Initially ~ acres Ultimately ~ acres 8 Will R ~s~ action comply with existing zoning or other existin~ land use restrictions~ ~s ~ No If No, describe briefly 9. What ' present land use in vicinity of project~ ~esidentia[ ~ Industrial ~ Commercial ~ Agriculture ~ Parkland/o~n space ~ Other Describe: 10. Does action involve a ~i~approvaJ, or fundin~ n~ or ultimately, from any other ~overnmenta~ agency (Federal, state or ~ Yes ~No If yes. list aBenc~s} and permi~appro~als 11. Does any aspectof~of e action have a currently valid ~rm[t or approval~ ~ Yes ~No if yes, list asency name and permiffapproval Wpe 12.As~resultyes of propos~NPOS~oaction will existin~ ~rmi~approval r~uire modification~ I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ^pp,icant/spons ....... /~i.~-/ f-!¢I/f'J Date: ¥ ,] Signature: If the action is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART II Environmental Assessment (To be completed by Agency) ^. Does action exceed any Type I threshold in 6 NYCRR, Part 617 127 if yes, coordinate the review process and use the FULL/LONG FORM C. Could action result in ANY adverse effects on, to, or arising from the following: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Historic, archeological, visual or aesthetic, or other natural or cultural resources; agriculturaJ districts; or community or neighborhood character? Explain briefly C3. Vegetat on or fauna, movement of fish or wildlife species, s gn f cant habitats, or threatened or endangered species? Explain briefly: C4 A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly C5 Growth, subsequent development, or related activities likely to be induced by the proposed action? Expfain briefly C6. Secondary, cumulative, or other effects not identified in C1~:67 Explain briefly C7 A change in use of either quantity or type of energy? Explain briefly. PART III Determination of Significance CTo be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (al setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; [e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL/LONG FORM E^F and/or prepare a positive declaration. [] Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide here, and on attachments as necessary, the reasons supportng this determination: Agency Name Preparer's Signature/Title [:*ate