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GNVIRONt1E�7'Al. CIIECF:LIST ' <br /> , ' • �' ' ($�0.00 Fee Required) � , <br /> `Lntroduction: The State Environmental Policy Act of 1971, Chnpter 43.21C, RC41, reauf.res all <br /> ;ta[e and local governmental agencies to consider environccental values both foz [heir ow� <br /> iceions and when licensing private proposnls. The Act also requires [hat an EIS Ee prep::ed <br /> :or all ma,jor actions significantly affecting the quality of the environment. The purpase <br /> �! this checklist ie to help the agencies involved deterr�ine whether or not a proposal is such <br /> a major aeeion. <br /> snease anewer Che folloving questions as completely as you can with the infornation prese:tl� <br /> :uailable to you. Where explana[ions of your answers are required, or where you believe an <br /> <zplanation would be helpEul to go�•ernment decision makers, include your explanatioa in t:e <br /> _2ace provided, or use addi[ional ;.ages if necessary. You should include references to a�y <br /> :eports or studies of which you are avare and ahich are relevant to the answer� you provi?e. <br /> ��mplete answers to these questions now will help all agencies involved with your propoea: <br /> tcr undertake the required environmental review without unnecessary delay. <br /> 3he following questions apply to your total proposal, not just to the license for which p�u <br /> are currently applying or the proposal for Which approval is sought. Your ansuera should <br /> include the impacts crhich will be caused by your propo al chen it is completed, even thoc:a <br /> completion may ncc occur until sometime in the future. This will allow all of the agenciee <br /> vhich will be involved to complete their environmental review nov, without duplicating <br /> paper work in the future. <br /> NOTE: Thia is a etandard form being used by all state and local agencies in the Sta[e of <br /> Washington for various types of proposals. Many of the questions may not apply to qour pr�pyo,SB�• <br /> If a question does not apply, just anawer it "no" and contiaue on to the next��que�s�o�+'(� � �� <br /> 10'� � �.� <br /> U <br /> ENVIRONME"1TAI. CNECKLIST FORM �s'J 6 '.Jr� <br /> ':r� <br /> 1. BACKGROITND c )�T� <br /> ' — ' ` • ' . . �..T V f�•iC �\•ylW <br /> I 7. Name of Proponent _ : . •. - ` „ �,:,.-. <br /> - . _ _ , �` = _ �.. =i'�..;�.:�ra , ., �_,- <br /> � _ \ ;, , <br /> 2, Addresa and 1'hone N�mber of Proponent: - _ , - <br /> � : t: . : ` ' ' ' � `' ` � � r. — <br /> C . �r�� r . J� e, � � � •, �� 1yNti ��. : ,7 " _ <br /> . � <br /> 3. Da[e Checklist Submitted � ` � �' ' _ <br /> { - -- � • . _ . <br /> q, Agency Bequiring Checklist C- � '- ` C �- ' ' ��'� " � �^ <br /> 5. Name of Proposal, if applicaole: �� ' <br /> 6. Nature and Brief Description of the Proposal (including but not limited to ite ai:e, <br /> general design elements, and other factors that vill give an accurace anderstanding ^ <br /> of its ecope and naturc) : = - " - "' ' � <br /> � ' <br /> ( 7. Location oE Proposal (descrihe [he phyeical setting of the propasal, as vell as tFe <br /> extent of the land area affected by any enviro .mencal impacts, including any other <br /> information needed to give an accurate understaiiding of the environmental aetting uF <br /> � . . . <br /> � the proposal) : � _ — _ . <br /> � - . � '�. •_ ; - <br /> 8. Estimated Date for Completion of the Proposed Action: <br /> � <br /> I <br />