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� _..._.._,._.,_-:� �.:�c::�_.,. � � <br /> . :O.00 '_e :�;e-=-�� • . ' . � � - . . <br /> - -recuctier.: ::�e S[ate E.•._:cr.-e�tsi 2c_±.c sct o_` i9i1 � ..' ` �-' :. <br /> , Ctapte: 43,?i� �CC, rec::ires u <br /> _tate and local ;e�•era�eata: z_er.c:es co censider eai•i:onr_ental valces �eth :or [nei: ou,-,� <br /> =ccicr.s aad anen :icensia"s ?=ir�ce prenosais. The �ct also :eauires p?g +. <br /> __: a11 -z7o= actions si2ni`icaatly z:°ect_ng .he quality ei the eavi;onaeat. ":ee,pYe��.-�_ <br /> _- :i:s c�ecKlist is ;o help the agencies iavolved deter�ia< wnethe: or ae; a - '���� <br /> � :az'o: action. :- -. _-_- -= =�_.: <br /> _ease ans�.er [:�< follouia2 questions as co-plecely as you �n ��i:h the ir.io--;at' <br /> -:ai'_a�le to you. '.:�e;e es�laaacions of �eur answe:s are reouired, or wne:e ycu , v <br /> =:,�lanation aould 'oe heip.• � -'=--_�'� --•� <br /> =�1 :o go�era:�eat decision �a'sers, include cou: es�lana,:toa i <br /> spac- pro��ided, o: use additionzl pages :° necessary. You should i^clude reze:ences te : <br /> reper;=_ e: st•scies of wnich you a:e �e;are and which are relevsnt to che answe:s }•eu - <br /> �_,?.e:e ar.s«e:s to tSese '^"`'-• <br /> auestions aox s:ill help all zgencies iavoived :oi.h your p:--,�,�_ <br /> :_ ar,der:ake the :eouired environaental review w•ithout uar.ecessar; delay. <br /> =`e :o:loc;ing questions a�ply to your total proposal, no: just [o the license for ;: <br /> -.a cur:ently applping or the �roposai for r;hich approval is sought. Your aas::ers s�..•:: <br /> -:clude the impacts which will be caused by ycur p:oposal e:hen it is ce�cleted, ere^ _ <br /> -�c�ietioa nay not occur c,^.til ;u.�eti�e in th= .uture. This w:ll alloc al? of the z . <br /> -::ici »ill be involved to ccnnle[e their envirenmental review IIOW� c;ithoct ;;uplicaei: : � - <br /> -?e= aor;c ir. the :uture. _ <br /> •�''==; :n+s is a standard �or� being used by all state an2 local a2encies ia ,he St�ca r" <br /> _��hi.*,Eton °or var�cus types of proposals. u.an�� o: the questions ray not appl±; .o }•c :_ - _ <br /> __ a auestion dces not apply, just answer it "no" and contiaue on te the n x� <br /> e i Guest:a::. <br /> -• :- �..: .T t-:�� , <br /> -' .30`-...\.�1L CHEC�LZST FaR'I ,, . - <br /> - • =:,C::GBOliVD <br /> -. Same of Propo:ent ��_,_ - <br /> 1, e= �� i-,� � �-tT ., <br /> _', �.:-. <br /> -. :lddress and Phone Suaoer of P:oponent: /ui: ; . n, �' j %� �"::,• . �,. _ <br /> i'; " " - _ � <br /> /� i <br /> _. Date Checklist Submitted__ -_ - - I �-� .;�•;-. <br /> . .�gency Aequ:ring Checklist . ��-„�-,• : - <br /> �. Sa�ae of Proposal, if applicable: - ;•� �- ,,, ,, ,, „ . <br /> cture and 3rizf Desc:iption oi the Proposal (i�cicdine Sut �ot l:�ited to ies size, <br /> _,ria:al design ele:�ents, and other :actors tnat will ¢ive an accurate ur.derstanding <br /> _ :ts scope snd nature) : / �,_. . - �;� , ;.- ; , „- - <br /> _. �� - '-�' - - _ . t-r � y4r'"-�' <br /> '. _. ,�a,icn of ?r000sal (descriUe the physical se[ting oi :he prenosal, as wel! as t' _ <br /> _:tent ef t:�e land area ai:ected 'oy any environr..ental impacts, including any otne: <br /> �ro r...atio: ae�ded to give an accu:ate underst�zndin� c: the environ�entei seet_�s - _ <br /> � prc�aszl) : i ,- . / _ � _. '_ <br /> _ , z <br /> —� � � � f �' �' " �i i r� - - '/ - � �/ � <br /> �_ , ,� �.� - "'�%� ,..,. ,,, �„�.s /�� � r'FH� - <br /> • _. _.cated �a:e °�r r�-.�lz�ion of the P:eoos2d action: i,S� i/�� •; t �i.--;,' <br /> ; � .,. , , _- <br /> -- --------___ __- t i- ! i �. i 7 S <br />