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1 <br /> . -- �-- �.�. <br /> , �..��. ' ' . <br /> IiNV1ItONA114NTAL CIIECBGST W � �1 � � U �5 n , <br /> U <br /> (a25.00 ��cc Requtred) $EP 18 19l8 �J <br /> � �VIIi0N111RN1'AL IM1II'ACTS � �.• f. <br /> ClTY OF GVERET/' xpinnntlons o(all "yes nnd "maybu" nnewere are roqulred) <br /> introduction: The Stnte P.nvironmentnl Policy Act of I97I, p�anmr.d �_,�[. � <br /> Chnptcr 47.21C, RCW, requires nll slote nnd locnl �overnmenlnl Yes Meybe No <br /> agenciee to rnnaidcr envtronmentnl valucs hoth for lhcir own � ) Gnrih, fYlll Ihc pmposN resuit in: <br /> ections nnd whcn Iicensing privnte proposnls. The Act nlso � ' <br /> requires �hnt nn EIS be prepored [or Nl major nctlons significnntly (a) Unatable en�th condlHone or in <br /> effeetlng the qunlity o[the envlronmenL The purposo o[Ih1e chm�gee in gcologlc eubetructuree4 �/ � <br /> checkllsl fs to help thn ngr.nctes involved Jetcrmine whclher or not � -- - - <br /> e proposal is such a majo� actton. � (b) Dlsrupliona, displacementa, com- y, <br /> . pactton or ovcrcovering o[the eollT � <br /> Plense annwer the tollowing queations ns completcly ns you can - - <br /> with lhe informntlou presently nvnila�le lo you, Whcre expinnattone (c) Chnnge 1n topogrnphy or ground � <br /> o[your enswers ure requirad, or wherc you bcllevc an expinnation � aurfnce relie[featureeY ' • <br /> would be hclp[ul to govcrnment declsiom m�kers, [ncludc your - -- — <br /> explanntion fn the spnce provided, or use aeldtttonnl pngr.e if � {d) The destruction, covering or modl- <br /> necessaty. You shauld lncludc reCerences to eny reports ar etudiie ticoNon of ony unique geologic or phyeicat � . <br /> ot which you ere ativare nnd which m•e relevnnt to the nnswera you [eeturea? . �/ . <br /> provida Completc answcrs to Oiese qucsttons now wtil Iielp N: - - <br /> egenctea lnvolve�with ywr proposnl tu undcrinke thc requ�red (e) Any increese tn wlnd or vreter - -_ � <br /> environmentnl review without unnecessn�y del�. croafon of eolle, either on or of[Iho eitet <br /> The folioiring questions apply to your total propoeal, not juet to Ihe • � (q Chnn�ea fn deposlHon or erosion ' � <br /> llcense for which you are currently applyinF or the propusal for I oC bench eunde, or changce in alltnllon, � <br /> whlch approvnl Is sought. Your ;uiawers should include the impacte ; �epositlon or eroston wLlch moy modily F <br /> which wlll be cuused by your proposnl when tt is completed, even � the channel o[a river or alreem or the � <br /> thwgh compleHon moy not occur unUl sometime in tho [oWro. Thie � bed o[the ocenn or any bey, intet or ? <br /> . will nllo�r all of the ngenclea which will be [nvalved to rnm�leto � ��ey � � � <br /> their envlronmental revlew now, without dupllenting pnperwork in — � <br /> ihc Nture. � Bx tanedon: (6) �xi/i,vG ExCA✓M�O,�/S � PA,Q�' LoT i,�riN�. <br /> C.) GRADING R�,C' R�It�r�ib � � i.� i�.r ' <br /> NOTG: Thfe fe n slnndnrd form bcing uecd by nll alnlo ond loca! . � <br /> egencles in U�e Statc o[Woehington tor vnrtoun types of propoaele. Air, Wlll the pmposal reault 1n: � <br /> Alany o[thc quesltons moy nol apply to your proposal. If e qneotlon <br /> dces not apply, Junt nnswer it"no" and wnNnuo on to the next (n) Alr emisstone or detertoretlon ot � �� <br /> queatlan. � emb�ent eir quelityZ �/ - <br /> � — — 6 <br /> ENVIR017ML•NTAL CttGCKLiST FORM (b) Tha crenllon of obJectionebla � • � <br /> odora? <br /> 1. BACKGROUND — — — � <br /> (c) Alterulion af air movement, mols- � <br /> 1. Nnme o[Proponent DUttynM iF�vDE4 joN FiPFEA� NDR �S. ture or tempernturc, ar eny chnnqa In � <br /> 7. Addreas ond Phone Nu�nbcr a[Proponen4 climnto, cithcr locally or regionetly7 (/ � <br /> ,1(Q� EASTLAKE AVE. EAST ' — -- — <br /> S A � �yh5 N . 9R/09 P.x Innntlon: Q <br /> — F )Ah�in�►c B�L� dNsTaucno,v D�vsr,,�,�� <br /> P <br /> �. pe�o Checkllel Su6milted \ 8 ] `�OLNRL L4�/.IG�N �'11A t ep��I. s� �rh.w.� �/��Gr�J ����'. <br /> � � <br /> �`. <br />