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9. Agency Requiring Checklist 131J/moo/r �� �G—PT <br />5. Name of Proposal, if applicable: <br />G. Nature and L'rief Description of the Proposal (including but not <br />limited to its size, general design elements, and other factors <br />that will give an accurate understanding of its scope and <br />nature): (�WSr2dc-7T G MIA-11 wa=Ft-CP/'45s(S-1 sr' ;r /- S 57 <br />iiaL��/G Gfizo� t L'Cwr� vier �co t F .Sr g <br />7. Location of Proposal (describe the physical setting of the <br />proposal, as well as the extent of the land area affected by any <br />environmental impacts, including any other information needed <br />to give an accurate understanding of the environmental setting <br />of the proposal): fWE si775 /s 15Z'74z2-404 I CdreCF' 2 S <br />AAyc:1 l lz-e- 6:�F 7b f S- Azi✓c S yr <br />l3ETLc-FfJJ r S !N//_� Lc'� F���E�j LVZ.4-Sj�LT. S/72--F J�/GL_ ICE <br />F/-'CLOSES W1 G ' N 1 L'r,'N ul�i �K FF_ �E . <br />S. Estimated Date for Completion of the Proposed Action: <br />9. List of all Permits, Licenses or Government Approvals Required <br />for <br />.the Proposal (federal, state and local --including rezones): <br />ST of Nwys fLaS .AF�lr4ti� Sk.vi Cn�1/</, <br />10. Do you have any plans for future additions, expansion, or <br />further activity related to or connected witli this proposal? If <br />yes, explain: <br />/,/OrzTH ARvL/o e*= <br />11 Do you know of any plans by others which may affect the <br />property covered by your prcposal? If yes, explain: <br />s-V <br />12. Attach any other application form that has been completed <br />regarding the proposal; if none has been completed, but is <br />expected to be filed at some future dale, describe the nature <br />of such application form: <br />