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, ' . r:NviaoHn�r:rr��nt, c►tr:cxr.isT <br /> {�;25. 00 1�cc Rcyuired) ,� � ry r � � � � <br /> io� �� <br /> Introduclion: Thr. Slntc Iinvironmeninl Policy Act of 1971, UIJ <br /> Chopicr 4:1.21C , RC{y, re�tiires al] stnte un� local govcrnmmrinl S�� 1 Z �y/f� <br /> ngencies to consider environmenlal vnlues both foi• thcir own CITY OF L'VLiIZG7'T � <br /> nctions nnd when licensing pi•ivntc proposnls. The Acl also plan,.. <br /> requires thnt an ]?IS Ue prci��red Cor nll mnjor uctions significantly ✓ � <br /> nffectin� lhc yunlity of the environment. The purposc of this <br /> checklist is to help the ogencics involved determine wl�ethcr or not <br /> n proposal is such m m�jor nction. <br /> Plensc answer the followin� qucstions ns completcly os you can <br /> •• with tiic informnlion presently nvnilable to you . {Vl�ere explanations <br /> of your ansrvers are reryuired, or wherc you believe nn explanalion <br /> would be helpful to government decision makcrs, include your <br /> explanntion in the spnce provided, or use ndditional pages if � <br /> necessnry, You should incliidc references to any reporis or studies <br /> of whicli you are nware and ivhich nre rclevnnt to the nnswcrs you <br /> provide. Complete nns�vers to these question� now �eill help all <br /> • agencies inaolved with your proposnl to undei•takc tlie required <br /> environmentnlreview wiUiout unnecessnry deluy. 1 <br /> The following questions apply to your tota] proposal, not just to the <br /> Hcense for which you nre currently upplying or the proposal for <br /> which npproval is sought. Your nnswers sliould include the impncls ' <br /> whfch will be caused by your proposnl when it is completed, even � <br /> though completion may not occur until sometime in t1�e [uture. This <br /> will nllow a>> of the egencies x�hich �ei11 be involved to mmplete . <br /> thGir environmentnl rr.view now, wiUiout duplicnting papertivork in <br /> the future. <br /> NOTE: This is n stnndnrd form being used by all stnte end locnl i <br /> agencies in the State of jVnshington tor various types ot proposnls. � <br /> Mnny o[ the questions may not npply to your proposal. 1f n question � <br /> does not upply, just nnswer it "no" and continue on to the next � <br /> � qucstion. � <br /> II�IVIRON111ENTAL CHGCKLIST FOR111 j <br /> i � <br /> i <br /> I. BACKGROUND � <br /> � <br /> 1. Namc ot Proponent �j ,qi.p�.i �2,��y. i <br /> , 2. Address nnd Pi�one NumUer of I'ro��onent: <br /> � luo� Ic�T" I <br /> _ 'S ,� •��••,,�i�L1J�naH 9°Z�lc� � <br />� .,fS- elrl�l ' <br /> 3. Dnte Checklist 5ub�mtted Z-�,;�.Y,iA� ��� �r�y r . <br /> ' <br /> � � <br /> I <br />