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. <br /> . , ' <br /> I <br /> . . <br /> � �� � t� [� OdC� � <br /> � ENVIRONMfiNTAL CIIECKLIST �' <br /> (Szs.00 Fee Required) ?� � -� �/ SEP 21 1978 <br /> CITY OF EVERETT <br /> Introduction: The State Environmental Policy Act of 1971, Chap[er 43.21C, RGZJ, .requires nll <br /> sGte and lucal Rovernnental agencies to consider envlronmental values both for tticlr own <br /> actions and vhen licensing private proposals. The Act also requires that an EIS be prep�red <br /> �or all ma.�or actione siqnificantly affecting the quality of the environment. The purpose <br /> of this checklist is to help th2 agencies involved determine whether or not a proposal is such <br /> a ma�or action. <br /> ileaae ansver the folloving quesciona ae completely as you mn raith the information presently ' <br /> available to you. Where explanationa oE your answers are requlzed, or where you believe an <br /> e�cplanation vould be helpful to qovernment decision makers, include your explanation in the ' <br /> spac� provided, or uae additional pa,::s if necessary. You ahould include references to any <br /> r�porta ar studies of vhich you are avare and which are relevant to the aneaers you provtde. : <br /> Complete anawers to these ques[ior.s nov will help all agencies iavolved vith your proposal ' <br /> to wdcrtaka the required environm.ntal review without unneceasary delay. • <br /> me tol],owing queations apply zo your total proposal, not juet to the licenae for ahich you � <br /> ae currently applying or the propaeal Eor vhich apptoval is suuaht. Your anewe-s should � <br /> faclude the impacts ahich will be caused by your propoeal when it is completed, even thaugh I <br /> empletion oay not occur until sometime in the future. This will allow all of the agencies <br /> frhleh vill be involved Co coe�plete their enviranmental reviev nw, vithout duplicating � ' <br /> paper wrk in the future. , • j � <br /> #OiE: Thia is a etandard form being used by all etate and local aaencies in the State•oE <br /> ifashiagton Eor various types of propoeals. Many of the questions may not apply to your proposal. <br /> Zl.a queation dcea not apply, juat anaver it "no" and concinue on to the next queation. � <br /> �fAp�NTAL CHECIQ.IST FORM <br /> 1. �11CRGSOIIND ^.,,, n <br /> r � . • <br /> 1. F�e of Proponent r- �-�•�c-,. • -�r�� ••�,i i f � ` <br /> Z lddrese and Yhone N�ber of Proponent: ' _; � '� � '" � ' � ' ' �•t <br /> ' - . �— ;931 � • —�no {, ,.�„ . �. .j - :� � � • <br /> 3. Date Checklist Su6mitted ' � � <br /> l. 1lgency Requiring Checklist C� Fv o'� � v�� - t ( <br /> 3. llame of Proposal, if applicable: � , -� - N� � � ' ' <br /> , � �� <br /> �6, lfature and Brief Description oE ehe Prrposal (including but not limited to its aize, `, <br /> smeral deaign elemen[s, and other f,��core thet will give an accurate underetanding <br /> of its acopa and nature) : j��� �'Ir y_ .. i� � . . __ I� r !' Ic� - ! M��y� ' � <br /> � � L � �' � ' � ii� . •,L;' .� �,.�e . ���._�" nYr!l .� . r � ri�� � .. '. <br /> 6N �l � nr� �.'i X � � 7 �'' . � 1 ' I <br /> ). �ocation of Proposal (describe ehe physical aettinq of a6e proposal. ae vell as the . �i <br /> ,,d�tent of the land area �ffected by any environmen[al impncta, including any other <br /> ,/��� infotmation needed to gtve an accurat� undezetandiag of t6e environmental eetting of <br /> x 'L1- tAe propoeal): ^ - ' i?„ � i„�. . .--R / ' <br /> ��,Zv ��. . I . . �(. ..r ( i- � i � r c y :S I v �l��t � t F' r�i ' � <br />, ��`�'�` �: ,.� � � „ �„ .. ti - � r.,�,. i ;' ` . - � . . 3 <br /> �-.. � <br /> a�� • !, Estimaced Date Eor Completion of tha Propoeed Actlon: � ��i �. -• � � I � / '% '��_ ' �i <br /> . i , <br /> : • <br /> . : <br /> 7 <br /> . . <br /> � <br />� . . <br />