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II <br />9. Liet ot all Permlte, L1 ses or Covernment Approvnln kc red for the E�CO�IOD7L (Ecdcra?., <br />etute ond locnl--lncluding rezonce): CI'PY Of' LULRETT — fiUILllING DEP'P. <br />L0. Do you l�nve any plan9 for future odditions,�expansion, or furthcr ac[ivity rciared to or <br />connec[ed with thie proposall If yes, explain: NO <br />11. Do you know of ar.y plans by otliers vhich may affect the property covered by your proposalY <br />If yca, explain: NG <br />12. •Attach any o[her application form that has been completed regarding the prOposul; if r:one <br />has been completed, but ia expected to be filed ar some future daEe, describe the natvre <br />of such applicatlon form: NONE _ <br />ENVIRONMENTAL L*iPACTS <br />(Explanations of all "yes and "maybe" answere are tequired) <br />(1) Ear[h. Will the proposal reeult in: Yee Haybe No <br />(a) Unatable earth conditions or i¢ changes in geologic su6structuresl _ _ X <br />(b) Disrupttons, dlsplacements, compactian or overcovering of the soilY � <br />(c) Change in topography or ground surface relief features2 � _ <br />(d) 17�e deatruction, covE:ring or modification of any ualque geologic <br />or physical fenturea? _ <br />(e) Any increase in wind or water etoaion of soils, either on or <br />off the site? _ — <br />(E) Chnnges in deposition or erosion of beach sands, or changee in <br />eiltation, depoeition or erosion mhich may modify the channel of <br />a river or stream or the bed of the acean or any bay, inlet or <br />lake7 <br />X _ <br />— � <br />X <br />_ X <br />Fycplanntion: 1(b) — Relocation of on—aito materials __ <br />1(e) — Minor topographical changes neceasary to site buildi.ngB <br />(2) Air. Will the proposal result '.n: <br />(a) Air emiseiona or deteriorc�tion of ambient air quality? <br />(b) The creation of objec[ionable odors7 <br />(c) Alterntion of nir movement, moisture or temperature, or any <br />ehange Sn climate, efthcr locally ur regionnlly7 . <br />Explanation: <br />(3) ilater. WS11 chc preposal teault in: <br />(n) Chane�e 1n eurrence, or the com se ar direction of vater <br />movrments, in cicher mar!:�e or fresti vntcra7 <br />, ` _ x <br />_ _ x <br />x <br />