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_. + <br /> � . - I <br /> , , ENVIRONhl£NTAL C1iBCSLIST � � (� �y � M � nD � <br /> � U -J <br />. � � ($25.00 Fee Required) 17 1978 <br /> MAR ' <br /> Introduction: The State Environmentnl,Policy Act of 1971, Y �F �vE�tETT <br /> • Chap— ter 93.21C , RC1V, requires nll state and local governme{�it� <br /> egencies to consider environmentnl values both for their own <br /> actions und when licensing privute proposals. The Act also <br /> requires that an EIS be prepared for nll major actions signiticnntly <br /> affecting tlie quality of the environment. The purpose of this <br /> checklist is to help the agencies inv�lved determine whether or not <br /> a proposal is such a major action. <br /> � Pleese answer the following questions as completely as Yw �an <br /> with the informntion presenfly availuble to you. ltihere explanations <br /> of your answers are required, or where you believe an explanation <br /> would be helpful to government decision makers, inelude your <br /> explanation in the space provided, or use ndditional o gs or studies <br /> necessary. You should include references to any rep <br /> of which you are aware and which are relevnnt to the answers you <br /> provide. Comp:ete answers to these questions now wili help all <br /> agencies involved with your proposal to undertake the required <br /> environmentalreview withoutunnecessary delay. <br /> The following questions apply to your total proposal, not just to the <br /> license for which you are currently applying or the proposal for <br /> which approval is sought. Your answers should include the impacts <br /> which will be caused by your proposal when it is completed, even <br /> though completion may not occur until sometime in the future. This <br /> will allow all of the agencies which will be involved to rnmplete <br /> their environmental review now, without duplicadng pnperwork in <br /> the future. <br /> NOTE: This is a standard form being used by all seSt�efan olasnls. <br /> agencies in the State of SVashington f to Vouru ro osal. If a question <br /> Many oC the questions may not apply y P P <br /> does not npply , just answer it "no" atid continue on to the next <br /> question. <br /> ENVIRONn7ENTAL CHECkLIST f'ORM <br /> I, BpCIZGROJND I <br /> (� r c[ <br /> 1. Name of Proponent I 11'1!�lU�I a �-' <br /> 2. Address and Phone NumUcr of 1'ropon,t�t: �O ` <br /> 2 f I L Tl���,-c! .n�/t7 . �'`� — <br /> -�C-��?�t�'(C� �1 ((1 2 1 �t7 �a S� <br /> 3. Dnte Checklist Submillcd <br />