State smart growth public infrastructure policy act



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NYS Department of State

STATE SMART GROWTH PUBLIC INFRASTRUCTURE POLICY ACT:

APPLICANT IMPACT STATEMENT

(2017)

DO NOT WRITE IN THIS SPACE

Application Number (If Any)


Date Received

DOS Program/Division/Project/Grant:

Applicant Information

Name of Applicant:

Federal Tax ID Number:

Name of Chief Administrative Official:

Telephone Number/Extension:


Title:

Fax Number:

Mailing Address:


E-Mail Address:


County or Counties:

Senate District(s):

Assembly District(s):


Type of Applicant: Municipality/Town

General Project Information

Total Project Cost:

Amount of State Aid Requested:


Amount of Local Share (if any):


Type of Project. Please check one of the following:

New Construction
Improvements to Existing Structure.
Other:

Please provide a brief explanation.

Project Title (no more than 10 words):

Project Description (brief summary statement):



Project is receiving or has received other grant funding or other public funds. (Please list)



In the past, project has received DOS grant funding. (Please list)



Project Review by other Agency. Please list each State Infrastructure Agency that has reviewed or is reviewing this project for compliance with the Smart Growth Public Infrastructure Policy Act.





PROJECT EVALUATION FOR CONSISTENCY WITH SMART GROWTH ACT

This project is consistent with the following smart growth criteria (Please check all relevant criteria. Please also provide a justification for each criterion, whether checked or not. Attach additional sheets as necessary):




  1. To advance projects for the use, maintenance or improvement of existing infrastructure:






  1. To advance projects located in municipal centers:






  1. To advance projects in developed areas or areas designated for concentrated infill development in a municipally approved comprehensive land use plan, local waterfront revitalization plan and/or brownfield opportunity area plan:






  1. To protect, preserve, and enhance New York State’s resources, including agricultural land, forests, surface and groundwater, air quality, recreation and open space, scenic areas, and significant historic and archeological resources:






  1. To foster mixed land uses and compact development, downtown revitalization, brownfield redevelopment, the enhancement of beauty in public spaces, the diversity and affordability of housing in proximity to places of employment, recreation and commercial development and the integration of all income and age groups:






  1. To provide mobility through transportation choices including improved public transportation and reduced automobile dependency:






  1. To coordinate between state and local government and inter-municipal and regional planning:






  1. To participate in community based planning and collaboration:






  1. To ensure predictability in building and land use codes:






  1. To promote sustainability by strengthening existing and creating new communities which reduce greenhouse gas emissions and do not compromise the needs of future generations, by among other means encouraging broad based public involvement in developing and implementing a community plan and ensuring the governance structure is adequate to sustain its implementation:





  1. To mitigate future physical climate risk due to sea level rise, and/or storm surges and/or flooding, based on available data predicting the likelihood of future extreme weather events, including hazard risk analysis data if applicable:




APPLICANT

In accordance with the Smart Growth Public Infrastructure Policy Act, Environmental Conservation Law Article 6, the applicant affirm that the Smart Growth Impact for the proposed project application has been assessed:
__________________________________________________________________

Name of Authorized Representative (i.e., Executive, Mayor, Supervisor, Manager)


__________________________________________________________________

Signature


__________________________________________________________________

Date




For DOS Use Only


Justification for Consistency or Inconsistency with Smart Growth Act is Approvable:
Justification for Consistency or Inconsistency with Smart Growth Act is NOT Approvable:
Reason:

Reviewed By:


___________________________________________________________________________________
Date:
___________________________

The New York State Secretary of State attests that the project, to the extent practicable, is consistent with all relevant criteria set forth in Environmental Law § 6-0107(2).

__________________________________________________________________

Secretary of State or Official Designee (Print Name and Title)


__________________________________________________________________

Signature


___________________­­­­________

Date






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