Who completes the Short Environmental Assessment Form?

The applicant or project sponsor completes Part 1 with project and sponsor information. The lead agency completes the impact assessment in Part 2 and determination of significance in Part 3.

What information does the form ask for?

It asks about the proposed action, site, land uses, zoning, traffic, utilities, natural resources, and potential environmental impacts.

Do I need a notary for the Short Environmental Assessment Form?

No. The applicant or sponsor signs and dates Part 1 without a notary; the lead agency completes and signs Parts 2 and 3.

How do I submit the Short Environmental Assessment Form?

The form does not specify a submission method or department. Submit it to the city department named on the form; check the city website for current contact details.

Ancram, NY · Columbia County

No notary required

Short Environmental Assessment Form

Applicants or project sponsors complete this form with project details and environmental information for a proposed action seeking approval or funding.

What this form is

The Short Environmental Assessment Form collects information about a proposed project, its location, the applicant or sponsor, and potential environmental effects. The applicant or sponsor completes Part 1 for an application for approval or funding; the lead agency completes the impact assessment in Part 2 and the determination of significance in Part 3. The form asks about land use, traffic, utilities, natural resources, and other project impacts.

Who needs it

An applicant or project sponsor seeking approval or funding for a proposed action completes Part 1, while the lead agency completes Parts 2 and 3.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This document is signed and dated without a notary; the applicant or sponsor signs Part 1, and the lead agency completes and signs Parts 2 and 3.

How to submit this form

1
Download The Form
Download the Short Environmental Assessment Form PDF.
2
Complete Part 1
The applicant or sponsor fills in project and sponsor information and answers the environmental questions using information currently available.
3
Gather Supporting Information
Attach a location map and any additional pages or information needed to supplement responses.
4
Submit For Review
Submit the completed form to the city department named on the form; check the city website for current contact details.

Frequently asked questions

Who completes the Short Environmental Assessment Form?: The applicant or project sponsor completes Part 1 with project and sponsor information. The lead agency completes the impact assessment in Part 2 and determination of significance in Part 3.
What information does the form ask for?: It asks about the proposed action, site, land uses, zoning, traffic, utilities, natural resources, and potential environmental impacts.
Do I need a notary for the Short Environmental Assessment Form?: No. The applicant or sponsor signs and dates Part 1 without a notary; the lead agency completes and signs Parts 2 and 3.
How do I submit the Short Environmental Assessment Form?: The form does not specify a submission method or department. Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Short Environmental Assessment Form doesn’t need a notary — but if you have another Ancram form that does, a commissioned online notary can help.