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. <br /> • ' •, L- `- . . <br /> 4. Agency Requiring Checklist rJere�' �wi�diNG� �.COI� <br /> T <br /> S. Name o[Proposal, if applicabie: . <br /> 6. Naturc and Brief Description of the Prcposal (incTuding but not <br /> limited to its size, generel design elements, and other facton <br /> that will give an accurat� understending of ita scope and <br /> nature)• <br /> �1 C�nr�' r���drv�,n��rw� — <br /> _�. <br /> 7. Location of Proposal (describe the physical setting of the <br /> proposal, ss well a� the extent of the land ares affected by eny <br /> emironmental impacts, including any other information needed <br /> to give an accurate understanding of the environmental setting <br /> of the proposel): � n r <br /> /.I.���enF � . ..e. Gol ba-r� � 35 IN� �� '7 �Q' <br /> .1` <br /> 8. Estimated Date for Completion of the Proposed Action: <br /> . N�ve.m��r `[ s� <br /> 9. List of all Permits, Licenses or Government Apprwals Required <br /> for the Proposal (federal, state and local--including rezones): <br /> ��I�,�r� excauc�u.�., �e+�,ol�f�c,v� + e�ee4rie�� <br /> 7V I J I . ' . <br /> 10. Doyou heve any plans for future additions, expansion, or i <br /> further activity related to or ronnected With this proposal? If <br /> yes, explain: <br /> �� <br /> 11 D•�you know of any plans by others which may affect the � <br /> property covered by your proposnl? IE yes, explain: • <br /> � J � <br /> 12. Attach any other application form that hus bcen completed <br /> regarding the proposal; if none has been completed, but is <br /> expected to be filed at some future date, describe the nature <br /> � of such applicution form: <br /> ; `�� <br /> I <br /> , ' I <br />