103 DORN AVE 2016-01-01 MF Import

9. Liet of all Permits, Licensea or Covernmen[ Approvals Required for the Proposal (federal� state and local--including rezones): City of EveTett buildin� FlUmbin¢ an3__ , electrical permits, i 10. Do you have any plans for futurc additions, expansion, or further activi[y relrted to or , connected vith this proposalY If yes, explain: No 11. Do you knoa of any p,lvaons by others which may affect the property covered by your proposal? If yea, explain: 12. Attach any other application form that has been completed regarding the proposal; if none has been completed, but is expected to be filed a[ some future date, describe the nature of such application Corm: None II. ENVIRONME\TAL I:4PACT5 (Explana[ions of all "yes and "maybe" answers are required) (1) Earth. Will the proposal result in: Yes 4f�be No (a) Unstable earth conditions or in changes in geologic substructures? _ — X (b) Disruptions, displacem�nts, compaction or overcovering of the soil? _ _ X (c) Change in topography or ground surface relief features? — — — (d) The destruction, cove:ring or modification of any unique geologic � or physical features? (e) Any increase in wind or water erosion of soils, either on or _— off the site? - (f) Cl�anges in deposition or erosion of beach sands, or changes in siltation, deposition or etosion which u�ay modify the channel of a river or stream er the bed of the ocean or any bay, inlet or lake? Exolanation: (2) Air. Will the proposal result in: (a) Air emi.ssions or deterioratior of ambient air quality? (b) The crcation of objectionable odors? (c) Alteration of air movement, moisture or temperature,,or any change in climate, eicher locally or regionally? Exvlana[ion: (3) F'atcr. Will the proposal resul[ i.n: (8) ChanePs in currents, or the course or direction of water movements, in eithcr marine or fresh waters2 _ X _ x_ X x _ _ X �/ 1