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4. Agency Requiring Checklist _e�'�V �r �'(��'�,•Grf- <br />5. Name of Proposul, if applicubl� <br />6. Nature nnd Brief Description of the Proposal (including but not <br />limited to its size, general design elements, and other factors <br />that will givc an accurate understunding of its scope and <br />nature): <br />7. <br />proposal, as well as the extent of the land area affected by any <br />environmental impacts, including any other information needed <br />to give an accurate understanding of the environmental setting <br />of the proposal): <br />8. Estimated Date for Completion of the Proposed Action: <br />9. List of all Permits, Licenses or Government Approvals Require <br />for the yProposal (federal, state and local--including rezones): <br />% I / y .�L ,�"Ut.«� <br />10. Do qou ha��e any plans for future additions, expansion, or <br />further activity related to or conne^ted with this proposul? Tf <br />yes, explain: <br />. —Li0 <br />� <br />il Do you know of any plans by others which muy affect the <br />property covered by your proposal? If yes, ea�plain: <br />- -1i o ' <br />12. Attuch any other application form that has been completed <br />regarding the proposal; if none has been completed, but is <br />expected to be filed ut some future date. describe the nature <br />of such npplication form: <br />�%D.�'ti <br />• <br />