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Southold. N.Y. 11971
(516) 765-1938
August 28, 1985
Genevieve Richards
Main Road
Southold, NY 11971
Re; Site Plan for
Genevieve Richards
Dear Ms. Richards:
The following action was taken by the Southold Town Planning
Board, Monday, August 26, 1985.
RESOLVED that the Southold Town Planning Board approve the
site plan of Genevieve Richards located at Main Road, Southold
for construction of a storage building, and the supplemental
landscape plan. Map dated January 31, 1985.
This site plan also received approval from the Board of
Appeals and was certified by the Building Department.
When the Chairman has endorsed the plan, we will forward
a copy to you.
If you have any questions, please don't hesitate to contact
our office.
Very truly yours,
~tl~~,tt:L~
BENNETT ORLOWSKI, JR., CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
By Diane M. Schultze, Secretary
cc: Building Department
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Southold, N.Y. 11971
(516) 765-1938
September 9, 1985
Genevieve L. Richards
Main Road
Southold, NY 11971
Re: Site Plan for Genevieve Richards
Dear Ms. Richards:
Enclosed please find a survey for the above mentioned approved
proposal which has been endorsed by the Chairman.
If you have any questions, please don't hesitate to contact
our office.
Very truly yours,
~RL~:S~~ ~k=
SOUTH OLD TOWN PLANNING BOARD
By Diane M.Schultze, Secretary
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TEL. 765-1 802
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
AUo b 1985
Aug. 5,1985
Planning Board
Town of Southold
Main Rd.
Southold, N.Y.
11971
Subject:
Genevieve L. Richards
Site Plan, Jan. 31,1985
Gentlemen:
The subject premises is located in a 'B' Light
Business District. Proposed use as storage for con-
tractors heavy equipment is not permitted in this
commercial district.
with the granting of use variance under Appeal
#3352 and special exception under Appeal #3353 dated
July 18,1985 this site plan qualifies for certificat-
ion in meeting zoning requirements.
Yours truly,
L/i,dv~~
EH:dsm
Edward Hindermann
Building Inspector
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A. Legal Data
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Vl. Lot, bolck and section number, if any, of the property
taken from the tax records
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V2. Name and address of the owner of record
~. Name and address of the person preparing the map
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v4. date, north arrow, and written and graphic scale
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v/S. Sufficient description or information to precisely define the
boundaries of the property. All distances shall be in feet an
tenths of a foot. All angles shall be given to the nearest
ten seconds or closer. The error of closure shall not exceed
one in ten thousand.
~. The locations, names, and existing widths of adjacent streets
and curblines.
1/
V 7. The location and owners of all adjoining lands, as shown
on the latest tax records.
vii. Location, width and purpose of all existing and proposed
easements, setbacks, reservations and areas dedicated to public
use within or adjoining the property.
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I 9. A complete outline of existing deed restrictions or covenants
applying to the property.
v~O. Existing zoning.
B. Natural Features
l/~' Existing contours at intervals of five or less, referred to
a datum satisfactory to the Board.
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2.
Approximate boundaries of any areas subject to flooding or
stormwater overflows.
3. Location of existing watercouress, marshes, wooded areas,
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rock outcrops, isolated trees with a diameter of eight inches
or more measured three feet above the base of the trunk and other
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significant existing features.
c. Existing structures and utilities.
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1. Location of uses and outlines o~ structures, drawn to scale
on and within one hundred feet of the lot.
2. Paved areas, sidewalks and vehic~ar access between the site
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and public streets.
3. Locations, dimensions, grades and flow direction of existing
)
sewers, culverts, and waterlines as well as other underground
and above ground utilities within and adjacent to the property
') 4. Other existing development, including fences, landscaping
and screening.
D. Proposed development.
/ The location of proposed buildings or structural improvement
2. The location and design of all uses not requiring structures
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such as off street parking and loading areas.
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3.
The location, direction, power and time of use of any proposed
outdoor lighting or public address systems.
oJ If 4.
5.
The location of an,<ilplans for any outdoor signs
The location and arrangement of proposed means of access and
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" egress, including sidewalks, driveways or other paved areas;
profiles indicating grading and cross sections showing width of
roadway, location and width of sidewalks and location and size
of water and sewer lines.
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6.
Any proposed grading, screening and other landscaping including
..
types and locations of proposed street trees.
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7. The location of all proposed waterlines, valves and hydrants
and of all sewer lines or alternate means of water supply and
sewage disposal and treatment.
~\~8. An outline of any proposed deed restrictions and or covenants.
0\f' 9. Any contemplated public improvements on or adjoining the
property.
\~ 10. If the site development plan indicates only a firest stage,
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a supplementary plan shall indicate ultimate development.
E. Any other information deemed by the Planning Board necessary to
determine conformity of the site plan with the intent and regulations
of this chapter. 7
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Southold Town Board of Appeals
MAIN ROAO - STATE ROAO 25
SOUTHOLO. L.I.. N.Y. 11971
TELEPHONE 15161 765.1809
ACTION OF THE ZONING BOARD OF APPEALS
Appeal No.
Application
TO:
3352
Dated April 9,1985
(Public Hearing June 27,1985)
[Appellant (s) 1
Mrs. Genevieve Richards
Main Road
Southold, NY 11971
At a Meeting of the Zoning Board of Appeals held on .July 18,1985,
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 VI , Section 100-60
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[l Request for
Application of GENEVIEVE RICHARDS, 64155 Main Road, Greenport, NY,
for a Variance to the Zonlng Ordinance, Article VI, Section 100-60 for
permission to use proposed building in this "B-Light" Business Zoning
District for heavy-equipment storage. Loca~ion of Property: 64155
Main Road, Greenport, NY; County Tax Map Parcel No. 1000-56-04-20.
WHEREAS, a public hearing was held and concluded on June 27, 1985,
in the Matter of the Appl ication of~I~i'{I~~~-.B.I(;HARD~; and
WHEREAS, the board members have considered all testimony and
documentation entered into the record in this matter, and it is noted
that no opposition has beenreceived; and
WHEREAS, the board members are familiar with the property, its
present use and the area in question; and
WHEREAS, the board made the following findings of fact:
1. By this application, applicant seeks permission to construct
a 36' by 70' storage building for heavy-equipment storage in this
"B-Light" Business Zoning District.
2. The premises in question is located on the north side of
the Main (State) Road, Greenport, NY, and is known and identified
on the Suffolk County Tax Maps as District 1000, Section 56, Block
04, part of Lot 20; and Lot #2 on a subdivision map of the Southold
Town Planning Board approved June 22, 1981.
3. The parcel is question contains a total area of 31,181 sq.
ft. (to tie line), with frontage along the Main Road of 258.84 feet
and is presently improved with a single garage-storage building
which is shown on survey dated January 31, 1985, to be set back
8 feet from the westerly property line, 23 feet from the northerly
property line, and 29 feet from the easterly property line located
along a private 25' right-of-way.
4. Article VI, Section 100-60 does not list "heavy-equipment
storage" as a permitted use in the "B-Light" Business Zoning
District, although garage structures for storage of materials
~~fo
~~ED:
(CONTINUED ON PAGE TWO)
-~.__._~..
August 1, 1985. CHAIRMAN, SOUTHOLD TOWN ZONING BOARD
OF' APPEALS
Form ZB4 (rev. 12/81)
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Pa ge 2 - Appea 1 No. 3352
Matter of GENEVIEVE RICHARDS
Decision Rendered July 18, 1985
and parking of vehicles has been permitted accessory with and
customarily incidental to any permitted use and not involving a
separate business.
5. For the record, it is noted that simultaneously herewith,
an application has been made and conditionally approved under
Application No. 3353 for a Special Exception.
In considering this application, the board agrees that the
use of the building as proposed for inside heavy-equipment
storage: (1) will not substantially change the character of
this business district; (2) will not be adverse to adjoining
properties; (3) will not cause a substantial effect of
increased population density which may be produced on available
governmental facilities; (4) in view of the manner in which the
difficulty aro~e and in consideration of all of the above factors,
the interests of justice will be served by allowing the variance,
as noted below.
Accordingly, on motion by Mr. Grigonis, seconded by
Mr. Goehringer, it was
RESOLVED, that the relief requested under Appeal No. 3352
in the Matter of the Application of GENEVIEVE RICHARDS for
permission to use proposed 36' by 70'-building for inside
storage of heavy equipment, BE AND HEREBY IS ~~~QVED SUBJECT
TO THE FOLLOWING CONDITIONS:
1. That the proposed building be no closer than eight feet
to the closest west property line (rather than five feet);
2. There be no placement of garage doors on the highway
side;
3. There be no obtrusive lighting which is adverse to
traffic or neighbors in the area;
4. There be no storage of any equipment or materials in
the front yard area;
5. The building not to exceed 20' in height;
6. The building must comply with Ch. 46, Floodplain Manage-
ment Law, if applicable; ~
7. There shall be fencing of the rearyard area with 6' high
stockade fence (not to exceed 6'6" in height);
8. Existing building must remain accessory to the proposed
new building, and shall not be used for living or habitable quarters.
9. In the event the right of the applicant to use the existing
right-of-way of the Estate of Joseph A. LaColla (along the easterly
property line) is terminated, this use variance shall become null
and void, unless an alternative access to the rear of the buildings
is arranged by the abutting property owners, and approved by the
Town Board of Appeals.
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Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, Doyen,
Douglass and Sawicki. This resolution was adopted by unanimous vote
of all the members.
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Southold. N.Y. 11971
(516) 765-1938
July 31, 1985
Ms. Genevieve L. Richards
Main Road, RFD
southold, NY 11971
Re: Site Plan for
Genevieve L. Richards
Dear Ms. Richards;
The following action was taken by the Southold Town Planning
Board, Monday, July 29, 1985.
RESOLVED that the Southold Town Planning Board refer the
site plan of Genevie~e L. Richards for construction of a storage
building located at Arshamomaque to the Building Department.
It was noted that this application received approval from
the Board of Appeals.
Would you please forward the filing fee in the amount of
$100 to the Planning Board office at your earliest convenience.
Very truly yours,
~~)~~
BENNETT ORLOWSKI, JR. ,CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
By Diane M. Schultze, Secretary
-:
cc: Building Department
.
March 15,
1985-
Members of the Planning Board
Town of Southold:
Presently the intended use of the proposed building
in question in no way deals with retail sales. The
proposed builliing is to be used for storage of equipment
only.
In the future if any changes are to be made, the
Planning Board would be notified immediatdy. The
necessary applicatiens would be made through the Planning
Board when and if the status is to be changed.
Thank You,
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Southold, N.Y. 11971
(516) 765-1938
May 21, 1985
Genevieve Richards
Main Road, RFD
Southold, NY 11971
Re: Site Plan for
Storage Building
Dear Ms. Richards:
The following comments are offered for the Board of Appeals
from the Planning Board after review at the meeting Monday,
May 20, 1985.
The Board has requested covenants and restrictions that the
proposed building will be for storage only. (none have been
received to date) .
It was noted at the March 4 Planning Board meeting that the
applicant does have the legal access over the right of way to the
East of the site; and the Board requested a copy of the deed
indicating this. (has not been received to date) .
The Board also notes that the zone line is indicated on the
key map, however, it should be on the site plan as well in order
to clearly indicate the zoning of the property.
If you have any questions, plecsedon't hesitate to contact
our office.
Very truly yours,
{)zJU1.LtX Qd.()w,{J f<..L / Il CL .
BENNETT ORLOWSKI, JR., CH1f~MA~
SOUTHOLD TOWN PLANNING BOARD
By Diane M. Schultze, Secretary
cc: Zoning Board of Appeals
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MAY ~ 1985
Southold Town Board of Appeals
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MAIN ROAD - STATE ROAD 25
SOUTHOLD, L.I" N.Y. 11971
IEU:PHUNE 15161 7651809
APPEALS BOARD
MEMBERS
GERARD P. GOEHRINGER, CHAIRMAN
CHARLES GRIGONIS. JR.
SERGE DOYEN, JR.
ROBERT J. DOUGLASS
JOSEPH H. SAWICKI
May 9,1985
Mrs. Genevieve Richards
Main Road RFD
Southold, NY 11971
Re: Appeals No. 3352 and 3353
This letter will acknowledge receipL of your recent appli-
cation. The members of the Board of Appeals will be conductin9
field inspections and environmental reviews as may be required
by State and local laws prior to scheduling your application for
a pub 1 i c he a r i n g .
It is requested in the interim that you proceed with the
[ xJ Planning Board [X J N.Y.S. D.E.C. [ J Town Trustees
in order that they may submit their written comments or recom-
mendations as early as possible. Upon receipt of their input,
your application will be scheduled for the next available hear
ing date.
If the above document(s) are submitted by June 1, 1985,
it is expected that the public hearing would be held about the
latt~r part of June. A copy of the notice of hearings as
published in the Long Island Traveler-Watchman and the Suffolk
Times will be sent to you as confirmation.
Please feel free to call at any time if you have any questions.
Your~ very truly,
GERARD P. GOEHRINGER
CHAIRMAN
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Planning
Du i 1 dill g
BoardV'
Departm2nt
By Linda Kowalski
(per resolution 5/2/85)
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TEL. 765-1802
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
t\~~ ~.b \;~~'5
March 28,1985
Planning Board
Town Hall
Main Rd.
Southold, N.Y.
11971
subject:
Genevieve L. Richards
Site plan dated 1/31/85
Gentlemen:
The subject property is zoned 'B' Light Bus-
iness. The use of proposed building does not com-
ply with permitted uses under Art. VI Sec. lOO-60A.
Applicant should be specific as to what use
premises will be used for in order for a certifi-
cation to be made. A varience may be necessary
if use does not meet those permitted under this
article.
Yours Truly,
Building Inspector
EH:dsm
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Southold, N.Y. 11971
(516) 765-1938
March 6, 1985
Genevieve Richards
Main Road, RFD
Southold, NY 11971
Re: Site Plan for
Storage Building
Dear Ms. Richards:
The following action was taken by the Southold Town Planning
Board, Monday, March 4, 1985.
RESOLVED that the Southold Town Planning Board refer the
site plan of Genevieve Richards for the construction of a storage
building located atArshamomaque to the Building Department
for certificiation.
The Board, also, requests covenants and restrictions that
the building will be used for storage only, as well as,
a copy of the deed showing legal access over the right-of-way
to the East of the property.
If you have any questions, please don't hesitate to contact
our office.
Would you please forward three (3) copies of the site plan
for our referral to the Building Department. Thank you.
Very truly yours,
3Lurtt Qr~ ftd- (L<)
BENNETT ORLOWSKI, JR., CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
By Diane M. Schultze, Secretary
cc: Building Department
.
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Southold, N.Y. 11971
(516) 765-1938
January 16, 1985
Genevieve Richards
Main Road, RFD
Southold, NY 11971
Dear Ms. Richards:
We are in receipt of your plans for the construction of a
storage building, and they have been reviewed by the TownPlanner.
This application will be handled as a site-plan, therefore,
prior to action by the Board the following is needed:
1) 6 copies of a survey drawn by a surveyor showing
only and the proposed building including any of the site
that apply. (see the enclosed list of site plan elements)
plan should be titled "Site Plan".
lot #2
plan elements
This
2) Clarification as to what type of storage the proposed building
will be used for.
If you have any questions regarding this, please don't hesitate
to contact our office.
Very truly yours,
BENNETT ORLOWSKI, JR., CHAIRMAN
SOUTHOLD TOWN PLANNING BOARD
;:D...iJJ:l;t OLaJr)kc) ~JJw
By Diane M. Schultze, Secretary
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TOWN OF SOUTHOLD
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(;,t~N G '7 1985
ENVIRONMENTAL ASSESSMENT - PART I
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PROJECT I~~Oro1ATION
~T:C!; ir.is ~ocu..1".e!'!t i<s de'Siqned to 3.ssi'St in deta!"":":":lnbg ',.f;,!!t:-:~r -:::e ict~on ~roposed 'nay ;,ave ! ~fgnffic:ant
!ff'!c: In the ,!~vln:r'!ment_ Ple~sa c~r.:olat.;! ::~e ~nti:,,'! Ja,:J. ~r.e~t. ;'ns',ot~r'5:o ~hesa .~uestions ~t~l :Je c:Jn'Si(l~~d
~ Jar:: of ':..,e aoP'~=J.t':on for aooroval ~nd may be sucj'!':,: to f'Jrthel'" '/e!"tf1cJ.t~on 3nd ;JubTic r~vi~w. Provide
1ny aQaitio~al information you Jelieve will ~e needed :0 ::~Qlete ?ART3 Z ana J.
:: is ~xcee::: ~at :::otetion of,the ~F ~~ll ~e depen~e!'!t 1" informaeion curr!~tTy available 3nd ~il1 not
.n"oly~ ~e~ ~..ucLeS..",:....s2a.r::;'!.or Tnvest1c;atl0n. If fi1io~!:'on I'";!outring such Jaci~ilJnal ".Iforil:. ;s~unavi1::acl~,
I~ tndlc~:a and 10e~TiY ~!C, lns~anca.
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_, CQnmerc~aI
t
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-'
Aporoxl~aca Jcr~~qe:
:'resantl~1 Af':2r Com"t~'::on
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:.'j"....
~rese!1t~y ~ft~r ~cmDlet1on
J.
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;. ~. Ar~ ~~!~~ 'e~~c~ :ut:~:~j~~s ~" '~je:': i::~? _____~~5 ~~
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6~ Ap?roxi~ate per:~ntJ~e of proposed project site with $i0ces: a~la~
greater _':.
,
II. H1. ",
~~ ~ 5::
1. Is project cont.iguous to. or contain a building or site i'isted ,:'m tne Nat10naf P.eTL::et of H!$ti)r,;~
Places? ______yes -L---No
8. What is the dapth to the wate' table? ______feet
9.. D? hunting or fishing opportunities pres2ntly exist in the project area? ~_Ve'$ ,,_,_-1to
10. Does project site contafn any species of plant or animal lffe that is identified as thr~3:tened or-
enc~nc~~ed - ______yes -----1'0. according to - Identify each species
Are ~~ere any unique or unusual land fo~s on the project sitz?
fonnaticns - _Yes -'---..-:~o.. (Describe
lZ. Is the p,"ject site p,esentTy used by the cc~unity 0' neighbo,hood as an open space o,'recreation
area - _Yes -----:.'{o~ "
11.
(Le.
l' -f
CI1LS..
dunes, other geological
13. Does the present site offer or include scenic vi~ws or vistas ~nown to be important to .the community?
______yes ---.llo
14. Streams within or contiguous to project area:
4. Name of stream and name of river to which it is tributary
I
15. lakes~ Ponds, Wetland areas within or contiguous to project area:
~ b~ Size (in acres)
a. UalT.e
16.
What is the dcminant ~nd use and zoning classificat~on within a 1/4 mi1~ radius of the project (e.g<
single family ,eside1m:!. R-2l and tIle scale of deveJop,~enc (e.g. 2 story'
"B. PROJECT OESCRI?TI0I4
1. Physic,l di~ensions and scale of p,"ject (fill in dimensions as appropriate)
I. Total contiguous acreage owned by p,"ject sponsor
'1" ac,ks,
ll. Project ac'eage developed: f\JI'acres initially; /I~'acres ultimately,
c. Projact ac,.age to remain undeveloped
d. Length of p,oject. in miTes:
li.j.
"
(if approp,iate)
e. If project is an expansion of 2xistinga indicate percent of expansion proposed; building square fcot
age .-' ,.: ':;1,} ~ developed acreage-'J.);..Q.f"J."
f. IIL'!:'be, of off-stl""!t parking spaces existing
:7~,. ; proposed i 'J"-'
g. ~axir.T'Jr.l vehicuiar trips generated per hour J J~:';" (upon completion of pr'JJec't)
h. If r<:!sid.;:ntial: Nw;".ber and type of housing units:
,'"
One 'Family
Two Fol1Tli 1y
Multiple FdJ11ily
Ccnco;nj.1iu~
Initial
Ul tlr.1.?te
i. If:
Orientat;cn
Nei~h~cr~aOd-(itJ-Kegional
Estimated Emplcyment
Co:rr.~rcial
.:::.::<~.
Industrial
J. Total hofght of tallest p,"posed structu'o c,
..
feet~
',~~!r<..:
"
;,
.
"
. "'.
. ~.,
. .
....
~,
..
~ ,
"
. .
S.
6.
-. 7.
.
.
.
"
..z. HOH much natu:-J,l mJ.tedal (f.e. rock. earth. etc.) will be re~o'l~d frem the site.. n<...;-r,,-.Jl.
tens ..
cubic yai
3. How m~ny acres or vegetation (trees~ shrubs. ground covers) will be removed fro~ site -r;;,-Q- acres.
4.
Wilt any mature for~st ~ver 100 years old) or ot~er local1y-fm~ortJnt ve~etation be removed by this
project? _Yes ~~Q
Are thpro any plans for re,v.~etation to replace that re~oved during construction? ~~ ______No
If single phase projact: Anticipated period of construction ~months~ (including demolition).
r.f multi-phased project: a. Total number of phases anticipated ~NO. . .
b. Anticipated date of co""'ence"'ent phase 1 Lmonth bear 'cinc1udin,
demolition)
c. Approximate completion date final phase L-r:.onth t',' Year. .:
d. Is phase 1 financially dependent on subsequent phas.s? .-=----Yes It{;.:
Will blasting occur during construction? ______yes ~No
Number of jobs generat2d: during construct1onL)'\!\ ; after project is complete _"
8.
9.
10.
11.
Hurr.ber of jobs el iminated by th1S project r~~.
1/
~i11 project require relocation of any projects or facilities? ______yes ______No.
If yes, explain:
12. a.
b.
/
11 No.
-;.-:--
! '
) -----~-
/. /-
Is surface or subsurface liquid waste dis~osal involved? _____yes
If yes~ indicate type of waste (sc~aget industrial I etc.)
c.
If surface disposal na~e of str~am into ~hich effluent will be discharged
13.
Will surface area or existing lakes, pones, stje~s, bays or other surface watarAays
decreased by proposal? ______yes ~No.
Is proj~ct or any portion of project located in the 100 ie~r flood plain? _Yes
be increased or
v<:
14.
15.
a.
Ooes project Involve disposal of solid weste? Yes v" No
If yes, will an ~,isting solid waste disposal facility be used?
y//',/-
______yes -=-No
b.
c.
If yes, give name:
; location
J \_____
{l/r1
. 'Yes-=--
d.
Will any wastes not go into a sewage disposal systEm o~ into a sanitary landfill?
16. Wfl1 project use her,fcides or pesticides? ______yes ~~o
17. Will project routinely produce cdors (more than one hour per day)? _Yes L-No
18. Will project produce operating noise exceeding the local affibfence nofse levels? ______yes ~Ho
19. \/i11 project resu1~ In an incre..se in energy use? ./Yes No. If yes. IndicJte type(s)
~/J. .ci' !.>:" :::.~
20.
21.
If water supply fs fro:':'l .....elTs indlc3.tc pur.:oing
. ,\ A
Total antic1p.!t~1 wdt~r usag2 ;:er day _\\,: I.'
Vu\ f~
gals/minute.
c~~aci ty
gJ I s/dJY.
22'. Zoning: a. ',.{hat is dcr.:inant 'zoning clJ.ssi;ic~ticn of site?
\' \
~
b. Curr~nt $;eclfic zonir.g cl~ssifiCJtian or si~2
S \
c.. fs prr:pos~d use C~"SiS:2r:t ....it~ ilre:iant zoning?
\), .<~.
d. If no. incicJt~ desired Zoning
.j,-.
oJ.
.:,~:_~.b~:
~:j(.j!~~.!;;:'~
-.:t-
."
f' ,,,~-'~~"~~:,,..
.
26. Approvals: a. [5 any Federal perT.'ilt req;.Jired?
V,~,; ---.;'fo
b. Does project involve State or Peden.1 fJncin:; or financing"
c. Local and Regional approvals:
City, Town, Village Board
City, Town, Villase Planning Soard
City, Town, Zoning Board
City, County Health Deoart~ent
Other local agencies
Ot~er regional agencies
State Agencies
federal Agencies
C. INFO~~TIG~~L CETAILS
Approval Recuired
(Yes. 110) (Typ~)
~10
Sue:;;i t:a.l
(Od, t::~)
Appro'!.::!.:
[Ca t:~:
At't~ch any additional infom.aticn a.s ll".ay be needed to c12.rify your project. If there a.re or may De iWy
adverse fm~acts associated with the proposal. please discuss suc~ impacti and the me~sure5 whic;, can b~
taken to mitigat~ or avoid them.
PREPARER'S SIS;';TURE:
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. TITLE:
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NOTES.
L:'>Uj;:'j::'9,h.~ CO,Ji'.'.l( MAP OA.TA:0f5r:r<xx:l'$K~.~Ft"p~20
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