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ENVIRON�tENTe1L C(1L•CKLISx • <br />($1r�3.00 Fee Required) <br />Introduction: Tt+.e State Environmental Policy Act of 1971, ChapL-er 53.21C, RCW, requires all <br />state and local governmental agencies to consider environmental values both for their ocm <br />accions and when licensing private proposals. The Act also requires that an EZS be prepared <br />for all major actions significan[ly affe::ting the quality of the em�ironc�ent. The purpose <br />nf this checklist is to help the agencies involved dete;:mine whether or not a proposal is sach <br />a major action. , <br />Please answer the following quesZions as completely as you ran with the infornation presently <br />avsilable to you. idhere explanations of your answers are required, or where you believe an <br />explar.ation would be helpful to•government decision makers, include your explanation in the <br />s�ac:� prwided, or use additional pages if necessary. You should include references to any <br />repnr[s or studies of which you are aWare and Which are relevant to the answers you provide. <br />Conglete answers to these questions nov will '�elp all agencies involved with your proposal <br />to undertake the required environnental review without unnecessary delay,, <br />The f'ollowing questions apply to your total proposal, not just to the license for which you <br />are currently applying or the proposal for which approval is sought. Your answers should <br />inclu',e the impac�s which wi11 be caused by your proposal when it is completed, even though <br />completion may.not occur until sometime in :.ae future. This wi11 allow all of the agencies <br />which c:ill be involved to conplete r.heir envir.�nmental review now, without duplicating <br />paper �aork in the future. . _ <br />NOTE: Tliis is a standard fom being used by a11 stz�e and local agencies in the State of <br />Wash;.ngton for va=ious types of propos�ls. Mzny of � lr'�,q�s��.ons��p �iot apply to your proposal. <br />If a question does not apply, just ansaer ir. no a�i3�coh�-�n�e �o�to� tri� next question. <br />� <br />ENVIRON�SEN'I'AL CHbCKLI�T EORN: <br />1, sncxcxemm <br />MAR 3C 19i� <br />czTx oF EVExE�T <br />-'^- � - .:apt. � S—�,. <br />1. Name of Proponent��V �!' �s J�(>7� CZ n n/' .•�. ..� ._ _l„,- <br />2, Address and Phone Nuu,�er of Proponent: a'�'l� �aa�� 5 w �L'dy`GT7- �'�✓�' <br />3. Date Checklist Su6mitted <br />4. /.gency Bequiring Check.list <br />5. Name of'Proposal, if applicable: ' <br />� <br />! <br />6. Nature and Brief Description of the Proposal (including but not liraited to its size, � <br />general design elemencs, and other factors that will �ve a1 accurate understanding I <br />of its �cope and nature) �•�+����y�- —�- -tl- X l�.T � 7� �!_�..tl� Sl.s[� h'f <br />Y '0'i5 . '-'- nCR. /7� !L.-�.tC\ <br />7. Location of Proposal (describe the physical setc:ng oE the preposal, as wcll as the <br />extenc oE the land area affested by any environmentul impacts, including any other <br />inEormation needed to give an accura�e ndersX cing oE the e^•.�i:o,,n.m�e9a-`s'. settir.� of <br />the proposal) : 1�C (�/0!1 lu r/��t'A S�,/1�.3� tlt�---�� ,�� <br />. r. .-- -�-^- - � - <br />8, Estimatgd Date for Cor•..let�.on oF t� Proposed Action: <br />