The Sutter Parking Garage Expansion (Project) is proposed within the Sutter Roseville Medical Center campus (Campus). The Campus is within the Northeast Roseville Specific Plan area. The Campus includes frontage on Secret Ravine Parkway and an entrance along East Roseville Parkway and is predominately surrounded by open space along the south and west portions of the Campus. Throughout the years the Campus has been developed with a main hospital building, acute care buildings, and outlying medical buildings and two (2) parking garages. In 2006, the Planning Commission approved a Conditional Use Permit which authorized expansion of the Campus from the originally approved 804,000 square feet to 1,100,000 square feet. At full buildout, the SRMC would contain a total of 738,500 square feet of licensed acute care spaces, 361,500 square feet of medical office building space for non-acute care and physician’s offices, and a total of 3,864 surface and parking structure spaces (parking space square footage is not included in the 1,100,000 square feet). The proposed Project was previously analyzed with the Campus expansion and approved by the Planning Commission in 2006. Further, the Project site has been previously disturbed and a parking lot with landscaping and lighting constructed. The applicant requests approval of a Design Review Permit for the expansion of an existing five-story parking garage with a new 192,000 square foot, six-story parking garage, consistent with the campus master plan and approved Conditional Use Permit. The Project is proposed to be located immediately to the east of the existing five-story parking garage and be connected to the future parking garage at each level; this would allow vehicles and pedestrians to travel between the two buildings. The architecture and design of the proposed Project would use the same finish materials and color palette to emulate the existing parking garage design. As part of the environmental review process for the Project, staff analyzed the Project and the future 100,000 square foot Medical Office Building 7 (MOB 7) in one environmental document. A combined Initial Study which led to a Negative Declaration analyzed both projects and found the Project and the future 100,000 square foot MOB 7 to be in compliance with the California Environmental Quality Act.