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EXHIBIT C - <br /> <br /> ENVIRONMENTAL REVIEW FOR <br /> NORTH PENINSULA NEIGHBORHOOD SERVICES CENTER <br /> HOUSING REXqTALIZATION PROGRAM <br /> <br /> Date: <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 ( )Single 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 improvements are proposed, check both boxes and identify <br /> wh~h irnnrovements are exterior. For exterior improvements to be made to a.. building which is at least <br /> 50 years old, please provide a site plan showing the location and 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 apartment. Extj means the outside of a home or a <br /> multifamily building. Improvements to be made outside an apartment, but inside a multifamily family <br /> · · " · ' ' Se <br /> building (such as in hallways, lobbies or sta rways) are also considered exterior for this purpo . <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/replaced <br /> ) Porch steps reinfor~edYrepaired <br /> )Floor/wall repair <br /> )Installation of smoke and carbon monoxide detectors <br /> <br /> )Energy education and assessment <br /> )Attic insulation <br /> )Door W~atherstripping <br /> )Water heater wrap <br /> ) Furnanee: filters <br /> ) Energy efficient showerhead <br /> )Electrical outlet gaskets caulking <br /> <br /> Other (Please identify): <br /> <br /> From: North Peninsula Neighborhood Services Center <br /> Contact person and telephone: <br /> <br /> <br />