Brockport, NY · Monroe County
Short Environmental Assessment Form
Applicants or project sponsors complete Part 1 of this form to provide project and site information for an application for approval or funding.
What this form is
The form gathers information about a proposed project, its location, the applicant or sponsor, and potential effects on land use, traffic, water, historic resources, and the environment. The applicant or sponsor completes Part 1, which becomes part of the application for approval or funding; the lead agency completes the impact assessment and determination of significance in Parts 2 and 3. Attach a location map and any additional pages needed to supplement responses.
Who needs it
An applicant or project sponsor uses this form when submitting project information as part of an application for approval or funding.
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 affirms the information is true and accurate to the best of their knowledge.
How to submit this form
- 1
Download The Form
Download the Short Environmental Assessment Form PDF.
- 2
Complete Part 1
The applicant or project sponsor completes all Part 1 items using currently available information.
- 3
Gather Attachments
Attach a location map and any additional pages needed to supplement responses.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the Short Environmental Assessment Form used for?
- It collects project and site information for an application for approval or funding, then gives the lead agency sections to assess impacts and determine significance.
- Who completes the form?
- The applicant or project sponsor completes Part 1. The lead agency is responsible for completing Parts 2 and 3.
- Do I need a notary for the Short Environmental Assessment Form?
- No. The applicant or sponsor signs and dates the form and affirms the information is true and accurate; no notary is indicated.
- How do I submit the Short Environmental Assessment Form?
- Submit it to the city department named on the form; check the city website for current contact details.