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:, <br />ENVIRONh11iNTAi. CfIF.CKI,IST <br />($50.00 Fee Required) <br />Ull -- - 1979 �` <br />JUN l4 <br />� CITY O� EVGRET� <br />piannin� u��rt ' <br />Introductiom The StaCe Environmentat Policy Act ot 1971, Chapter 43.21C, RQJ, requires all <br />stat� and local government:al a�encie� to con�ider environmPntal values bo[h for their own <br />acti.ons and when licensing private proposals. The Act also requires that an EIS be prepazed <br />for all major ar.tio�is signiEicantly affecting the quality of the environment. The purpose <br />of thi� checklist is [o help the agencies involved dcterriine wliether or not a propoyal i.s sach <br />a major actipn. <br />Plcase answer the follocaing questi.ons as completely as you r�n caith the information presently <br />aviilable to you. lJhere explanations of your :ansiaers are required, or whcrc you believe an <br />explanation would be helpful to �overnment decision makers, incl.ude your explanation in the <br />space provided, or use addi�ional pages if. n�ecessary. You should include reference„ to any <br />reports or studi.es of whicli you are aware and cohich are relevant L•o the anss.ers you provide. <br />Complete answers to these questi.ons nocr will help all agsncies involved with your proposal <br />to undertske the required euyironmental revie:a without umiece�sary dclay. <br />Tlie following questions apply to your total proposal, not just to the license for w:�ich you <br />are currently applying or the nroposa, for cahich approval is souoht. Your ans�:ers should <br />include the ispacts cohich caill be cau;ed by ycur proposai when it is co:npl.eted, even though <br />corpletio;a may noL• occur unti2 son:etime in tlie future. Thi� �ai11 alloa a11 of the ag�±ncies <br />��rnich wil.l. bc in:•olve!d to connlete th�ir e�tvironmental review noca, coithoul- duplicatiag <br />pzper work ;.n tne future. <br />NO'fE: This '.s a sl'andard form being used by all state and, local agenci.es in the State of <br />��la:hington for various types of proposals. ?fany of tlie questions nay not apply to your pro�osal. <br />If a question does not ap��ly, just anscaer it ^no" and contiuuc on to the r.est question. <br />EPNIrOV`12::TA_L CHECKLIST FOP.��I <br />1. SACI:GROUi7D <br />e <br />1. Name of Proponent _G�j �� �F��,�rq�J <br />2. Address and ?hone ;vumber of Proponent: ��.z/ /JJRD/Sn'd ,-vy-oF/-i, Lr.//KN —��Jo 3 <br />�5'S- S 72_�_ <br />3. Date Checklist Submitted �'-/Z• 7� • <br />4. A�ency Bequiring Chec4list �� % F Fc�rtbr� /�J(����n.j .!�E�7`• <br />5. A'ame of Proposal, if applicable: � � <br />6. tSa[ure and Srief Dczscri.pti.on of thc Propusal. (zncluci�ino Uut no[ limited to its ,ize, <br />general design e.lement;:, cad other Eactors Chat will give an accurate undersl:anding <br />oE its scope nnd nature): Ann�r.o.� nF r-ie���Ri 71 FX�sri,U� SiTr- _ <br />7. <br />Location oE Pr.oposal (de_.cribe the physical seCLing oE tfie proposal, as well a:. �hr_ <br />exLent of th� l�nd nrea aLfected by any env.ironmentnl impacts, :including �ny ol:hes <br />intormation nceded to give an accurate undcretanding of [he envi.ronmental sci:�ing of <br />tlic prupoaal):/1 ;Pnrio,v n��,f%NLf.wSi.4-r3/i—OE_�ZYlLC�n/ -✓l/7F/t[F,✓ Gi4Y q.s1_�Qo iir <br />1�E/�i/._�r�l._J1.N .G1157f�i�_.S'Lc,C�` C'��lllid��_!n_'�r7�4C�C;ilaE_�E��S2�2�k2y._ <br />.'%/iIOKA♦ �F•n Aw� T_�i• Ti�.�' �^1�... � l�nni �� �.�.. _ � .�r� rf_ <br />i /: \.' . L-I..� / .l � T <br />EstimiCed Da�c Cor Cowpletion uE LLe 1'ropo::ed Acttoii: SEP.T_�� __, <br />