Laserfiche WebLink
� <br />�.I <br />I <br />I e'� <br />�:� - <br />:u_ <br />,; <br />� ' -.,._ <br />--Y����.��_�._ <br />Y I 11.1 <br />. <br />�•� r <br />e-i o.� <br />PnoPOSED <br />. ...g:'�335 . / SIT6 ' <br />� :' >r:,:.h��',: �''1 <br />, al � `h�.l:x�r ., � <br />a�?`�� a'aox'� . <br />a� C�� <br />�•i • ' <br />1 <br />� er Ve w.��-e <br />qTV 0/ tY[�STT R�NMIN� OtIT. <br />._ . . .... . .. . <br />,.: : <br />�-� <br />■.i Ic lai <br />11-1 1 C-1 <br />ENVIIiO:1h7CNTAL CIIECKLIST <br />($25.00 Rec 12equired) <br />Inlroduclion: Tl�e Stn�e Cnvironmentat Policy Act oC 1'J71, � <br />Chopter 43.21C, ItC{Y, requires olI stnte und locnl govcrnmentel <br />ugencies to con�ider environmentnl vnlues both for lheir own <br />netlons oncl ivhen llcensing private pro, osals. The Act also • <br />requirca that an HIS Ue prepnred for nll mnjor nctimis signiticantly <br />nfCecling tho qunlily o[ the environment. The purpose o[ this <br />checklist is to hel�� the ogencies involved determine whether or not, <br />a proposul is cuch n major nction. <br />� Plense unswcr the following queslions ns camplelely ns you cnn <br />�with Uic in[ormalion presenlly nvniluUlc lo you. Whcre expinnudons <br />o[ your answers are required, or where you believe nn expinnntion <br />would be helpfui to govcrnment decision mokers, �include your <br />explonutlon in the spnce provided, or use addit3on¢1 pnges i[ <br />necessnry. You should indude reCerences to any reports or stuP <br />o[ which you ure nware nnd tivhicli nre rclevant to the answers yo� <br />provide. Complefc nnswers to tliesc questlons no�v wlll help nil <br />agencics involved with your proposN to undertalce qie required <br />��� environmentulreview without unnecessury delny. <br />The [ollowing queelfons apply to your total proposnl, not just to lhe <br />� license for �vhich you nre currenlly npplying or thc pro�osnl for <br />which approvnl is soughL Your nnswers should inelude the im�nets <br />whtch will be enused by your proposul when it is completed, even <br />lhough complelian may not occur until sometime in the tuture. This <br />will allow all o[ ti�e ngencies which wlil be involved to complete <br />lhcir environmentnl revlew now, wilhout duplicutlng pnperwork ln <br />lhe fulure. . <br />NOTT: Th1s is n slendard form 6c'.ng used by ell state nnd local <br />agencies in Ihe Stale of 1Ynshingtan for varioue types of propesals. <br />Many ot the quesHons mny not wpply te your proposnl. It e questton <br />does not apply, just answec ±t "no" and contlnue on to tl�e next <br />question. . � � <br />� ENVIRONniCNTAL CHECItLIST FORM <br />I. DACILGROUND � <br />1. NtvncofProponent b[--h'l V C/2CilJ/n/ .TQ <br />. S. Addresa and Phone Numbcr o[ ProUonent: <br />9, <br />