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- EXHIBIT C - <br /> <br /> ENV1RONSEENTAL REVIEW FOR <br /> NORTH PENINSULA NEIGH:BORHOOD SERVICES CENTER <br /> HOUSING REVITALIZATION PROGRAM <br /> <br /> Dale: <br /> <br />A. This is to request an Environmental review for a proposed project at the following address: <br /> <br />B. This address is a ( )~ing]e family home ( ) An apartment Age of bldg. if known <br /> <br />C. The improvements to be made to this home~/apartment are: ( ) interior* ( ) exterior* <br /> NOTE: If both interior and exterior impravements are proposed, check both bc~xes and idemif~.' <br /> which irrwroveme~. For exterior Lmprovements to be made to a..building which is at least <br /> 50 years old, please provide a site plan showing the location ~d extent of the improvements to the <br /> building, a work write-up order and/or plans and specifications of the improvements. <br /> *Interior means the inside of a home, or an ~artment. Exlerior means the outside of a home or a <br /> mulfifam, fly building. Improvements to be made outside an apartment, but inside a multifamily family <br /> building (such as in hallways, lobbies or slaJr~,'ays) are also considered "exterior" for this purpose. <br /> <br /> D. The improvements will consist of the installation or construction of: <br /> (.) Doors and window repair/replacement including screen doors/windows <br /> ( ) Plumbing fixtures repaired/riplaced <br /> ( ) Porch steps reinforced/repa/red <br /> (.)'Floor/wall repair <br /> ( ) Installation of smoke and carbon monoxide detectors <br /> <br /> ( )Energy education and assessment <br /> ( )Attic insulation <br /> ( )Door Weatherstripping <br /> ( )Water heater wrap <br /> ( ) Fumance filters <br /> ( ) Energy efficient shower'head <br /> ( )Electrical outlet g~.skets caulking <br /> <br /> Other (Please identify): <br /> <br /> From: North Peninsula Neighborhood Services Center <br /> <br /> Contact person and telephone: <br /> ? <br /> <br /> <br />