Port Orchard, WA · Kitsap County
SEPA Environmental Checklist With Supplement D
This checklist helps describe a proposal’s environmental effects for agency review and is completed by the applicant submitting the proposal.
What this form is
The checklist gives the reviewing agency information to help determine whether a proposal may have significant environmental impacts and whether mitigation or further analysis may be needed. It asks about the applicant, proposal schedule and location, permits, and environmental topics such as land, water, plants, animals, and transportation. For nonproject proposals, the instructions call for applicable sections and the Supplemental Sheet for Nonproject Actions (Part D).
Who needs it
Applicants submitting a proposal for agency review may need to complete the checklist, including the applicable sections for a nonproject proposal.
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 checklist is signed without a notary; the signer just signs and dates it.
How to submit this form
- 1
Download The Checklist
Download the SEPA Environmental Checklist PDF.
- 2
Complete Applicable Questions
Answer the applicable questions accurately and carefully, using the instructions for nonproject proposals when relevant.
- 3
Gather Supporting Information
Attach information that helps describe the proposal or its environmental effects, such as available plans or studies.
- 4
Submit To The City
Submit the completed checklist to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the SEPA Environmental Checklist used for?
- It helps an agency assess whether a proposal may have significant environmental impacts and whether avoidance, mitigation, or further analysis may be needed.
- What information does the checklist ask for?
- It asks about the applicant and proposal, its location and schedule, needed permits, and potential effects on environmental topics such as water, wildlife, land use, and transportation.
- Do I need a notary for the SEPA Environmental Checklist?
- No. This checklist is signed without a notary; the signer just signs and dates it.
- How do I submit the SEPA Environmental Checklist?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This SEPA Environmental Checklist With Supplement D doesn’t need a notary — but if you have another Port Orchard form that does, a commissioned online notary can help.