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910 SE EVERETT MALL WAY DAIRY QUEEN 2016-01-01 MF Import
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910 SE EVERETT MALL WAY DAIRY QUEEN 2016-01-01 MF Import
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Last modified
5/19/2017 6:41:29 AM
Creation date
2/13/2017 9:04:36 AM
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Address Document
Street Name
SE EVERETT MALL WAY
Street Number
910
Tenant Name
DAIRY QUEEN
Imported From Microfiche
Yes
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u VI��.YI�YLJ1 <br />� ' ess thanv$1,000,000 value - $SO <br />.,000,000 value or more - $!00 <br />�:Ila ,��5u1lL��i <br />' 1�1�1R ? 3 t981 <br />� ' i0�s Etli�itL'T <br />!ntroduction: The State Environmental Policy Act of 1971, Chapter 43.21C, R�1�:.'p�9u <br />:tn[e and local governmen[al agencies to consider environmental values hoth for th2?lzrtoWn .. <br />iction� and when licensing private proposals. Tlie Act also requires that an EIS he prepnred <br />'or all major actions si`nificantly affecting the quality oE the environment. The salpisesuch <br />�f this checklist is to help the agencies involved del•ermine whether or not n prop <br />major action. <br />lease answer the folloving questions as completely as you can with the Snformation presently <br />vailable tb you. ldhere exp7anations o`. your answers are required, or where you believe an <br />xNlanation would be helpful to government decislon maY.ers, inc:ude yaur explanation in the <br />pac=_ provided, or use additional pnges if necessary. You should include ref�rences to any <br />eports or studies of which you are aware and Nhich are relevant to the answers you provide. <br />omplete answers to these questions nov will help all agencies involved with your proposal <br />o undertake the tequired environc�ental revicw wiChout unnecessary delay. <br />he following questions apply to your total proposal, not just to tha license for which you <br />re currently applying or the proposal for :�hi�u= aro ocal when ithis cocnpleted,ee�enh�hough <br />nclude the ivpacts which �aill be caused Uy y P P <br />hichewill be involvedutoucoeipleteetheirienvironmental review'now,a�,�i houtlduplicatinancies <br />aper Work in the future. <br />p'�; This is a standard form being used by all o�atheaquestionsamayCnot applyetatyourUproposll <br />�shington for various types of proposals. NanY <br />f a question does not apply, just answer it "no" and continue on to che next question. <br />NVIROA'MEt�TAL CHECKLIST FOR2�1 <br />BACKGROUND <br />N/cus �loMEs INL — ,eoFir �I � <br />1. Name of Proponent �/�5 �D�� T��_ �J S'r <br />1 <br />Z, pddress and_ Phone ru�aber of Proponent: —^�Tr ��/A 4lI7nQ <br />v �- "' — - — <br />3 - ZO - 8 . — <br />3. Date Checklist Submitted �F E(/E��� <br />y, �;ency Bequiring Checklist �_ �- <br />5. Name of Proposal, if applicable: <br />6� generaladesigneelementsptand otherefactorsathatnwilligiveuannaccurateeunderstanding� <br />D/,�� D /LUNG O �T/ <br />of its scope and nature) : CLF�4,C/NG �� �� ��DUNY �' � r� " 75.�' <br />SNRLL BE Fl[[�D -Io � �,�... - <br />environmencal impacts, including any other <br />7, Location of Proposal (describe the physical setting of the proposal, as well as [ e <br />extent of the land area affected by any � �i/S�y <br />information needed to give- an accu�a�t� YndZ97 n�ngO°� �hjQ�� °� JD 1$etting o <br />!N <br />[he propusal) :%/�E 3/'� /5 � .r cin. rM/� /7o,¢/ii/%16E Sw'¢!� <br />G4N0 S��YL_ :: ����� lU?,�f/ e�" �• r �/ /���/y <br />. <br />�—+— n. �w�� ivA1////C TiC�IC /�%7iYL�0_�s�"" •�-- <br />g, Estimated Date for Completion of the Proposed Action:. <br />_ _ .. �__ .. n. .�i� O�PM/7'S ,4PE � <br />7JlE[E,4FT��. <br />h7 <br />
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