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�, <br /> \ <br /> ` � . ENVIRON111)iNTAJ. CIIIiCICLIST <br /> _ ) (E50.00 fee Required) �� � <br /> Introductioa: 'Phe Stnte �nviromnentc�l ruiicy Act of 1971, ' � <br /> Chupttr 93,21C, RCW, requires all stntc and ;ocul governmental <br /> agencies to eonsidcr environmental vulues both for their oivn ' <br /> actions nnd �vhen llcensing privnte prt�posalti. The Act also <br /> requires that an �IS hc prepared for all mnjor actions signi[icantly <br /> afCecting the qunlity ot the envtronment. The purposc of this <br /> . checklist is to help the agencies involved dr,tcrmine whether or not <br /> a proposal is such a major action. , <br /> Please answer the following questions as completely ns you can <br /> With the informntion presently nvuiluble to you. �Yhcrc explanutions <br /> of your answers erc required, or where you bclieve nn explanation <br /> would be helptul to government decisiom m�kers, include your <br /> expinnation in the space pravided, or use udditional pages if <br /> . necessnry. You should include references to nnp reports or studies <br /> ot which you ure ativnre and which are rclevnnt to the nnswers you <br /> provide. Complete nnswers to tliese questions now �vill lielp nll <br /> agencies involved tivith you� �roposal to undertake the required <br /> environmental revieiv witl�out unnecessary delay. <br /> The folloiving questions nppIy to your total proposal, not just to tlie <br /> ltcense for which you nre currently applying or the proposal for <br /> ' which upproval is sought. Your unswers should include ttie, impacts ' <br /> which tvill be caused by, your groposal when it is completed, even <br /> � Uiough completion may not occur until somctimc in tlie future. This <br /> will nllow nll of lhe ngencies which will be involved to complete <br /> their ettvironmental review now, witliout duplicuting paperwork in <br /> the futurc. , <br /> NOT�: This is u stnndnrd form Ueing used by nll stnte and locul � <br /> agencics in the Stntc of Wnsl�ington for vurious ty�pes of proposals. <br /> r9tuiy of the questions mny not npply to your proposal. If a question ' <br /> does not npply, just answer it "no" and co�itinue on to thc next <br /> question. . <br /> � ENVIROI�IIIENTAL CH�CI{LIST FORIIi . <br /> l. BACKGROUVD <br /> l. Name of Pr�ponent M.D.E. Partnershia • <br /> 2. Address nnd Phone NumUcr of 1'ropoucnt: <br /> 3809 Broadwa Everelt WA 98201 <br /> ZG: 232 -2l2(v <br /> 3. Dnte Checl:list Submilted � � 1�D <br /> . . ��� -�5 �9ao <br /> � E�E�� <br /> • • CIT P��F�ng oeP�. : <br />