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t <br />/^ <br />r.i�v>>;o;�ru:r��•n�. cur.cE:L�sT <br />(SS0.00 1'cc Required) ._� <br />Incroductinn: Thc State GnvironmenCal Policy Act oE 1971, Ch:ipCer 43.21C, RCId, rcquires all <br />>Cate and local �;o�'ernmental aEericies to consider envirunnencal values UoCh for [heir okn <br />ictions and when licensing privatc prnposal,. 7'he Act also requires that an IiIS bc prepared <br />(or al.l major acelons si{p�iCican U p nffec[inf: Che quali�y of the environmenl'. The purpose <br />�t Chfa checklist i, to help [he aCencfes im�ulved de[ermine wheChcr or noC a propos�l is such <br />i major accion. <br />'lease 2nswer [he fol.lowin_e, quesCions as complecely as }•ou c�n with the informaCion presently <br />rv ailablc to you. l.fi cre e:•:planaeion� of your �nswers are r.equircd, or wlicrc you Uclieve an <br />�xplanation M•ould bc l�elpful [o govcrnmen[ decisiun r.ial:ers, include your c�:plana�ion in thc <br />:pace provided, or use additional pages if necessary. 1bu shoi�ld includc reCeience; to any <br />:eporl's or s[udies of �,�>i�1� you are ata;n-e and wliich are relevanc �o che ans�ers }•ou provide. <br />:omplccc ansticrs to thesc que::Cions noa wil.l help all agenci.es involvcd taith your pi•oposal <br />:o undcrCake [he required enviionrienCal revicw �aithout unnecc;:sary dclay. <br />'he follo:ring questi.ons app7.y [o your tot�l proposal, noC just bo che li.cense for �hich you <br />�re cun'en[)y appl�•inG or Che pro� osal. fer whicL approval. i:; sou�;hC. 1'our ansirers should <br />nclude the impacts wliich i.�ill Ue caused hp y���i• proposal afien iC is compl�Ced, even l'hough <br />•o;�;pleCion r�ny noC occur unCil someCir.�e ir. ch. (uture. 7'his will all.ow all. of Che �c,encies <br />�hich will Ue involved lo co�rilcee thc•ir enoiro:r.;�ental review no�., wiCl�ouC duplicaCiag <br />�aper work in the fu[urc. <br />!0'1'E: This is a standard forr: Ucini' csc'd <br />dashi-ngton for various types o[ proposals <br />II a qucscion does not apply, jusi 11's'°cl <br />it2VI1:01':9E:CfAL CIt1iC}:1.1ST F012:1 <br />by ,�17 scnie and lncal a�;encies in the State of <br />M:�ny of th� qucstior.s r��y noC apply [o �•our proposal.. <br />iC "no" and conti_nuc on Co tlic nc>:t question. <br />�.. Itncxc.�:aU^:n � go S�P =K. <br />1. <br />2. <br />3. <br />4. <br />5. <br />ENGtN6ERlt�SC� � FlSNe-2MAN5 AT_-.--'__-�-; <br />Rame of Proponent E�IERE"fT ___ _ - <br />Address and� l'lionc Nunber oE Propone.nt: ��l�O__i�oQti'�K <br />Av c__,�Yv �R� <br />1n/As H-� nr �'ro rc . 2 S GJ — 3 l l_7_ ------ -- <br />�� 'r. 1�80 _ <br />DaCc Chec4:]isC Subr:iicced_ FELL-7._,_=_�__ -- <br />Ay;ency lequiring Cliccl:li.sC Gr� oF_``�F-R�-r -- <br />Namc oi Proposal, if applical,lc: N l�___—�-- <br />G. raCurc nnd ];rict 1)escripl'ion <br />fencral dcsi,n,n eleiacn[s, :md <br />oC ics scopc and naturc): � <br />�..�..n.. RUILDING iG.O�K <br />of Che }'rr.pu�al (includin}; UuC not 1.ir�iCed Co iCs si^.e, <br />ochcr f;�clore/� th:�C,�ai11 gi��o �a1�n1 haccuryIr �CeSm�G�:rtdiS/AfC.i.s- <br />� 1. 1 . _ I �. w i r_ �.i /.Ll/� C�t' _ l--_ _- <br />r <br />�_-----� _._--- <br />��tc�.N E�.d? ��i.E_ <br />7. Loc;acion nf Propos:+l (descrihc tl�c ph}'sic�l. sec[in�; oC the propos.�l, as �:ell as Che <br />estenC of t}�e �la»d are❑ afCecced Uy any environr.;ent:i] i.;•�pactc, i»cludin��, �ny otlict' <br />inCot�nacion nei•ded to f;iv�� an accuralc un�lerslan:lin�; of Che envi.ronmencal secting of <br />, �2. � Soc�rH oF ��nt:,_'�ENGrN�r2lN� <br />thc propus:i])o I_ocASto�v SS—.L� 5-�—= <br />�:�_�.s <br />F,a���� rN__�_LA�.�P__ y�1'.D �3Rcg�_____--�--- <br />_ ,1 <br />8. lscimated Uacc fur Corq,lction of tl�e Prnposcyl AcC1on: <br />T�►vc � _, 19 0 <br />3 <br />