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, , • ($25. 00 Fee Required) <br /> l <br /> Introduction: The Stntc F.nvironmental Policy Act of 1971, <br /> Chapter 43.21C , RC{V, requires ull state nnd locnl governmentul <br /> egencies to consider environmental vulues both for their own <br /> ections nnd when licensing private proposnis. The Act nlso <br /> requires thnt un EIS be prepared for all major actions significantly <br /> at[ecting the qunlity of the environment. The purpose of this <br /> checl�list is to help the agencies involved determine whether or not ' <br /> a proposai is such a mujor action. <br /> Please nnswer the following questions as completely es you can <br /> • with the in[ormation presently availnble to you. {Vhere explanntions <br /> of your enswers ere required, or where you believe nn explanation <br /> would be helptul to government decision makers, include your <br /> explanation in the spnce provided, or use additionul pages if <br /> necessary. You should include references to any reports or studiea <br /> of which you are awnre and which are relevnnt to the answers you <br /> provide. Complete nnswers to Lhese questions now will help all <br /> egencies involved with your proposnl to undertake the required <br /> environmental review without unnecessary deley. <br /> The [ollowing questions apply to your total proposal, not just to the <br /> licensc for which you nre currently upplying or the pruposal for <br /> which npproval is sought. Your answers should include the impacts <br /> which will be caused by your proposal when it is completed, even <br /> though completiom m�y not occur until sometime in the future. This <br /> will allow ctll of the agencies which �vill be involved to complete <br /> their environnental review now, without duplicadng paperwork in <br /> the future. <br /> NOTG: This {s a stundnrd form being used by ell stnte and IocN <br /> egencies in the State of �Vashington far various types o[ propocNs. <br /> Many of the qucstions mny not apply to your proposal. If n question <br /> does not apply , just answer it "no" and continue on to the ne:ct <br /> question. � <br /> ENVIRON111ENTAL CHECKLiST FORh7 <br /> I. BACKGROUND <br /> i. Nnme of Froponent __qff; l ;.at�d nm�r��,�n �n I <br /> 2. hddress nnd Phone h'umber o[ Proponent: I <br /> One Lake Bellewe Drive , 13ellevue , KA 98005 <br /> (206 ) 455-9%10 <br /> 3. Date Checklist Submitted �y <br /> �i/�v <br />- , <br />