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� <br /> • • � <br /> 4. Agency Requiring Checklist City of Everett <br /> 5. Name of Proposal, if applicable: <br /> � 6. Nature and Brief Description of the Proposal (including but not <br /> limited to its size, general design elements, and other factors <br /> that will give an accurate understanding of its scope and <br /> nature): <br /> Dental Clinic <br /> M�rr�.,e IN,040 -F-�' <br /> 7. Location of Proposal (describe Uie physical setring of the <br /> . proposal, as well as L`�e extent of the land aren affected by any <br /> � environmental impacts, including any other information needed <br /> • to give an necurnte understanding of the environmentnl setting <br /> of !he proposal): <br /> Southeast corner of Colby �< 38th Streets, flat <br /> site, building will be located on west end of lot, <br /> par ing wi z at t e east ena. <br /> 8. fistimated Date for Completion of the Proposcd Action: <br /> r^ebruary, 1979 <br /> 9. List of all Permits, Licenses or Government Approvals Required <br /> for the Proposal (federal, state and locai--inoluding rezoncs): <br /> City Building Del�artment <br /> ]0. Do you have any plans for future additions, expansion, or � <br /> furUier activity related to or connected with this proposal? It <br /> yes, explein: <br /> No <br /> 11 Do you kno�v of any plans by others �vhich may atfect the <br /> property covered by your proposal? If yes, expinin: <br /> No <br /> 12. Attnch any other applicntion form that has been completed <br /> regnrding U�e proposal; if none has been completed, but is <br /> expected to be filed at some future date, describe the nnture <br /> ot such nppiicution form: <br /> None <br />