Form

Date *

/ Month / Day Year

SEP Civil/Solar Rep

Solar Site Address *

Street Address
Street Address Line 2
Town or City	Village / Hamlet / NA
Postal / Zip Code	Country

Permitting Authority *

Assessors Parcel # *

School District *

GPS Coordinates *

# of Acres *

# of Parcels *

Nearest Substation

Distance to Substation

ISO Zone

Utility Provider *

Interconnection Review

3 phase on-site @ street frontage Located in easement Distance to 3 phase

Parcel Characteristics *

11+ Acres Open Field / Farm Land Wooded Wetlands Unobstructed Southern Exposure Acres of Usable Upland

PV Analysis

Pass Fail

Notes:

Zoning District

Lot Coverage

Zoning Analysis SEP

By-Right Special Permit Undetermined Environmental Issues Solar By-Law

Zoning Comments

Front Yard Setback

Side Yard Setback

Rear Yard

Owners Name *

First Name Last Name

Other Owner's Name

First Name Last Name

Owners Phone Number *

- Area Code Phone Number

Owners E-mail

Owners Address if Different from above

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Were these issues discussed with Land Owner

Flooding Intermittant Streams Areas that remain Wet Rare and Endangered Species Conservation Restriction Adverse Topography

Notes from discussion

Google Street 3 phase

Google Aerial

Street view of Site

Outline Parcel Aerial

Topographic Plan (all layers) Satellite Image

Topographic Plan (all layers)No Satellite Image-Basemap

National Wetlands Inventory (Wetlands and Riparian Checked)

Assessors Report/Tax Roll

EAF Mapper Short Form

Rare & Endangered Mapper ( if needed) Link http://www.dec.ny.gov/imsmaps/ERM/viewer.htm

Parcel Proximity to Substation

Date of Acceptance

- Month - Day Year

Project Developer ( to be completed by SEP Admin.)

Preliminary Site Analysis (New York)