Bergen, NY · Genesee County
SEQR Short Environmental Assessment Form
Applicants or project sponsors use this form to describe an unlisted action and provide project information for environmental review.
What this form is
Part I asks the applicant or project sponsor for project details, including the location, proposed action, land affected, current land use, and permits or approvals. The form is for unlisted actions and includes sections for agency environmental assessment and determination of significance. Complete the applicant portion when submitting a project for review; the form does not state where or how to submit it.
Who needs it
An applicant or project sponsor seeking review of an unlisted action completes Part I with project and permit information.
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 form is signed and dated without a notary; the applicant or sponsor certifies the information, and no notarized attachment is identified.
How to submit this form
- 1
Download the Form
Download the SEQR Short Environmental Assessment Form PDF.
- 2
Complete Part I
The applicant or project sponsor fills in the project information and certifies it with a signature and date.
- 3
Gather Supporting Materials
If needed, add attachments or reference supporting materials, as the form instructs the agency to do when necessary.
- 4
Submit to the City
Submit the completed form to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the SEQR Short Environmental Assessment Form?
- It is a form for unlisted actions. The applicant or project sponsor describes the project in Part I, while the agency completes the environmental assessment and significance sections.
- Who completes this form?
- The applicant or project sponsor completes Part I, providing project information such as the location, proposed action, land affected, and any permits or approvals.
- Do I need a notary for the SEQR Short Environmental Assessment Form?
- No. This form is signed and dated without a notary; the applicant or sponsor certifies the information, and no notarized attachment is identified.
- How do I submit the SEQR Short Environmental Assessment Form?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.