Environmental Permit Review Worksheet

Project Information

Project Name Project Location Applicant Name Application Date Reviewer Name

Permit Type(s)

Project Description

Environmental Considerations

Item	Applicable	Details/Comments
Air Quality	Yes No
Water Resources	Yes No
Wetlands	Yes No
Wildlife Habitat	Yes No
Hazardous Materials	Yes No
Noise	Yes No
Cultural Resources	Yes No

Required Actions / Recommendations

Reviewer Comments

Date of Review