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. <br />` <br /> p <br /> I <br /> I, <br />� <br />� <br /> I <br /> . .__._.�_�__..-. <br />� ENVIROh^,7ENTAL CitGCY.LIST <br />� '' . • � , (SbD.00 Fee Required) _ <br /> i • <br /> En[roduction: The State Environmental Policy Act of 1971, Chapter 43.21C, RCW, requires all <br /> state and local governmental agencies to consider environmental values both for their ovn <br />�� actions and when licensing privatr proposals. The Act ala�o requirca thnt an EIS be prepared <br /> far all ma,jor actions signifLcantly affecting the quality of the environment. The purpose <br /> of this checklist is to help the agencies involved determin> whe[her or not a proposal is such <br /> e aajor aceion. <br /> ?ieaee ansver the following questions as comple[ely ae you can with the informa�ion preaently <br /> available to you. Where explanationa of your anawers are required, or where you believe an <br /> ��r�lanation would be helpful to government decision makers, include your explanation in the <br /> ,�.ee provided, or use edditional pages 1f neceaeary. You should include references [o any <br /> :e{.wcte or studiee of Which you are aaare and which are relevant to the answers you provide. <br /> G^cplete ans�ers to these questiona now will help all agencies involved with your proposal <br /> co undertake the reyuired environmental review without unnecessary de.lay. • <br /> 'She following ?ueetiona apply to your total proposal, not �ust to thc license for ahich you � <br /> ace currently applying or the propoeal for which approval is sought. Your answera ehould � <br /> ilnclude the impacte which will be cauaed by youz proposal when i[ is completed, even though <br /> complation may not occur until sometime in the future. This will allou all of the agencies ', <br /> r+hicH will be involved to complete their environmental reviev now, vithout duplicating <br /> paper work in the future. , <br /> NOTE: Thia ia a etcndard forc� being used by all state and local agencies in the State oE �, <br /> 'Aaahington for various tqpee of proposals. Many of the ques[ions may noi apply to your proposal. , <br /> Df a question doea not apply, juat answer it "no" and continue on to the next q�ieation. � <br /> ERVIRONHENTAL CNECP.I.IST FORM <br /> i <br /> 11. BACKCROUPfi � <br /> : , <br /> 1. Name,of Proponent �i . .. ,� ,,• �ti� �•^:15` ���.c: . ��K:�.� r,lr� Tr•- �1 ►.�ce1 I <br /> 2. Address and Yhone Number of Proponent: , �,•••• • L c_ V �i r s= � � t-': � =�l- . <br /> ,�����,�� \��� . �'�,�r•.� -�,� . �. l. , •�...�;-� - '1�11t,• � <br /> 3. Date Check].ist Submitted <br /> 4. Agency Requiring Checkliat "–'{� � ,�n���r� ��;i'.i�.� +���i' w�'i" <br /> 3. Name of Propcsal, if applicable: \/I[z �=j�t �� �:_F..1 e' �M��c+;l� , .\ �.1 <br /> 6. Nature and Brief Description of the Propoeal (including but not limited to its eize, <br /> general design elements, and other factors tha[ will give an accurate underatanding <br /> � of its scope and nature) ' J�;-,;cn < . G•(•G�` � . t. ��'� t':r__�=r1! *''-� . . <br /> I' �` .1 � �)1P��'� ♦�i� -� ii. 1-� 1�"_ 1.�. ' �._l: -��.11 � '�i'� - ':7 .�:.:ll :\If ���T-..' <br /> . i �ii�� �.� r. 1 _� I�) \.�• '���...� �7 ^ .:���t•.1� \7 T�� •�LC �J \l� � \ � <br /> i 7. Lo :atiun of Proposal (describe the physical aetting of the proposal, as well ae r.he <br /> ' extent of the land area affected by any environmental impacts, including any other <br /> informntion needed to 'give an accutate understanding of the environmental aetting of <br /> the proposal) :1';: �^'i:'.Tk 1'� i�ti_'. cNTI � =�AT' \,'o .- F.;�L- ^� <br /> i \ ' � � - ��� YT •L '�, ti �2Q� ..?. - - 1��i i ••r i`�iC J 1 <br /> ^� .. \,, . `t — - <br /> 'r.'-�.� � r. :r�.1 =r.' w�v '"_�C.. l �>: ��=1� E N �_ �=C'�.ti ��1' _ <br /> 8. Estimated Date for Completion of [he Propoeed Action: ,�.• 4.`�.T 1''��1`� <br /> � <br /> c <br />