(a)

Land Resources.

Does the project site involve:

(1)

Changes in relief and drainage patterns

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(2)

A landform or topographical feature of local or regional interest

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(3)

An area having importance for wild plants and animals of community interest

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(4)

An area of soil instability – greater than 12% slope or organic soils, peats or mucks at or near the surface

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(5)

An area of bedrock within 6 feet of the soil surface

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(5)

An area with the groundwater table within 10 feet of the soil surface

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(6)

An area with fractured bedrock within 10 feet of the soil surface

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(8)

A drainage way for 5 or more acres of land

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(9)

More than 50% impermeable surface

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(10)

Prime agricultural land

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(11)

Wetlands and marshes

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(12)

Removal of over 25% of the present trees

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(b)

Water Resources.

Does the proposed project involve:

(1)

Location within an area traversed by a navigable stream or dry run

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(2)

Greater than 10% change in the capacity of a water storage facility or flow of a waterway within one mile

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(3)

The use of septic tank-soil absorption fields for on-site waste disposal

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(4)

Lowering of water table by pumping or drainage

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(5)

Raising of water table by altered drainage patterns

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(6)

Lake frontage

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(c)

Biological Resources.

Does the site involve:

(1)

Critical habitat for plants and animals of community interest

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(2)

Endangered, unusual or rare species of:

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a.

Land animals

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b.

Birds

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c.

Plants

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(d)

Human and Scientific Interest.

Does the project site involve:

(1)

An area of archaeological interest

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(2)

An area of geological interest

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(3)

An area of hydrological interest

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(4)

An area of historical interest

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a.

Historic buildings or monuments

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b.

Buildings or monuments of unique architecture

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(5)

An area of identified community recreational use

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(e)

Energy, Transportation and Communications.

(1)

Does the development increase the traffic flow in any collector system by more than 10%?

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(2)

Is the development traversed by an existing or planned utility corridor (gas, electricity, water, sewer interceptor, communications, storm sewer)?

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(3)

Is safe exit and access provided for?

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(f)

Population.

(1)

Does the development increase by more than 10% the school population of any school serving the development?

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(g)

Comments. Comments on any of the above which may have a significant environmental impact:

(h)

Appendices and Supporting Material.