01/31/2001 Env Bd Packet - Laserfiche WebLink

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Revised 2/99 ENVIRONMENTAL ASSESSMENT WORKSHEET Note to preparers: This form is available at www.mnplan.state.mn.us. EAW Guidelines will be available in Spring 1999 at the web site. The Environmental Assessment Worksheet provides information about a project that may have the potential for significant environmental effects. The EAW is prepared by the Responsible Governmental Unit or its agents to determine whether an Environmental Impact Statement should be prepared. The project proposer must supply any reasonably accessible data for — but should not complete — the fmal worksheet. If a complete answer does not fit in the space allotted, attach additional sheets as necessary. The complete question as well as the answer must be included if the EAW is prepared electronically. Note to reviewers: Comments must be submitted to the RGU during the 30 -day comment period following notice of the EAW in the EQB Monitor. Comments should address the accuracy and completeness of information, potential impacts that warrant further investigation and the need for an EIS. 1. Project title 2. Proposer 3. RGU Contact person Contact person Title Title Address Address City, state, ZIP City, state, ZIP Phone Phone Fax Fax E -mail E -mail 4. Reason for EAW preparation (check one) EIS scoping Mandatory EAW Proposer volunteered Citizen petition RGU discretion If EAW or EIS is mandatory give EQB rule category subpart number and subpart name 5. Project location County City/Township �A Section Township Range Attach each of the following to the EAW: • County map showing the general location of the project; • U.S. Geological Survey 7.5 minute, 1:24,000 scale map indicating project boundaries (photocopy acceptable); • Site plan showing all significant project and natural features. 6. Description a. Provide a project summary of 50 words or less to be published in the EQB Monitor. b. Give a complete description of the proposed project and related new construction. Attach additional sheets as necessary. Emphasize construction, operation methods and features that will cause physical manipulation of the environment or will produce wastes. Include modifications to existing equipment or industrial processes and significant demolition, removal or remodeling of existing structures. Indicate the timing and duration of construction activities. c. Explain the project purpose; if the project will be carried out by a governmental unit, explain the need for the project and identify its beneficiaries.