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TO BE COMPLETED BY APPLICANT <br />g. Proposed measures to reduce or control transportation impacts, if any: <br />None <br />I5. Public Semen <br />a. would the project result in an increased need for public services (for example: fire pro- <br />tection. police protection, health are, schools, other)^ if so. generally describe. <br />No <br />b. Proposed measures to reduce or control direct impacts on public services, if any. <br />None <br />16. Udfities <br />a. Circle utilities currently available at the site: a ectncu stun rater use <br />ce to ep on nitary serer septic system, other. <br />b. Describe the utilities that are proposed for the project, the utility providing the service. <br />and the general Construction activities on the site or in the immediate vicinity which might <br />be needed. <br />Building addition will connect to utilities serving <br />existing building <br />C. SIGNATURE <br />The above answers arc true an fete to th t of my knowledge. I understand that <br />the lad agency is relyin ,I���/",......... <br />Signature: .... .GJ........................ <br />Date Submitted: :1J. 27/.P..2................................................. <br />EVALUATION FOR <br />AGENCY USE ONLY <br />10 i <br />