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� <br />,:'.� ,-' . . , , L+.vinudrl�:V1'.U. C3ECXLIST <br />Intro-; �e State Environmentsl Policy Act of 1971, Chapter 43.21C, Q��, requtrea all <br />scace and local governmental agencies Co cansider environmeatal values boch for Cheir owst <br />actions and When liceasing private propasals. The Acc also requires thac an EIS be prepared <br />for all ma,jor ac[ions siga.iFicantly affecting the quality of ehe environaiene. The purposQ <br />of this ehecklist iy te help [he ageacies involved determine vhether or noc a proposal is such <br />a major acticn: <br />Please ansver the follwiag queseians as completelq as you can v�eh che information presently <br />available to y�, {�}��r¢ �l��ions af your ansvers ate required, or vhere you believe aa <br />e�cplaaation vould•be helpful to gaverneenc decision makers, include your e_cplanation ia che <br />sP��'- provided, or use additional pages if lecessary. You should include reEerences to any <br />reports:or studies of w!L{ch you are avare aad vhich are relevanc to the ar.svezs qou p=o�de. <br />Cemplete aasvers to these quescions cov vi,7,7, he],p .a� age�cies involved crith your propeyal <br />to uadertake che requtred emrtrenme�tal reviev cri[hout u�ecessary delay, <br />The f���g qnestioas appLp to yo�xr total proposal, not juat to the ltcease Eor vtiich ya� <br />include tlrr �ac�iIIB or'the proposal for Which apprwa.I is sought. Your anszrers should <br />completian eap nat occ�ur rmt�ii s�e�..(�ed�ytheufutureosa�isea iN is comp],eted, even chaug[r <br />Wyich yi� }Je� tJJI(C wil,l a11ov a11 of the agenra na <br />tR'�oIved to caszptece thei= enviroameatal reviev nov, without duplieae3ag <br />pape= wrc in tye.fucure. <br />N�t This is a staadard farm beinggueed bp�a],1 state and local ageacies ia the State of <br />WZ+hingcan for.various types af propaaals. �1a¢y�of the.questions aay nat applq to.pour prop��sal <br />Ii` a 4uestioa dosa not apply, j�t � iL na' aad. cantiaue oa, to the nest questioa.. <br />��2�li .�iiT6L (�ECSLIST' F�i ' <br />� 1. <br />B6CRGROII.ID <br />1- Name.of Proponeac <br />2_ <br />3. <br />Addreis aad Phone. :J�ber o£ Proponenc: �I(aSi ��� /�!� ' <br />� S�,ONon�t�5 'i6A��o,33 . <br />Date Checic.l3st Submitted . ,d�J(a. 14 P,2 � <br />4- ABm�9' �4uiring <br />S.. Nae.of Propusal,. iPapplicable: N0611"OU p��, RE�„�O'Lt'7f.� <br />6. Nature and Btief Descriptio¢ o� ttr� PropesaZ (�a��g but not liaited to its size, <br />gmeral desiga.elemeats, and ather factors�ehat crt7,1 give an accurate understaading <br />ot' its.scope and.natnre)= {�FpAI�,/ �p,ult.C) • 3 5TOwV <br />COMI��E IGm.� Au7. <br />7• Locatinn of Propaaal (desc:ibe the physical settinq of the proposal, as eaell as the <br />exeenc af the laad areu affeLted by any enviroamental impacts, including any ather <br />infozmatioa needed�to give an accurate understanding af the environmental settiag oE <br />Chfl pro�os�l): 2827, IJORTOU OU I.iO�TOU h p,�� y.� oF NEwit.r. <br />— PA�Mefd�( IM17oGi TFIh— P� rv� 1 'UOn.T'OI <br />���Dafs. IMDec, c - <br />Y Y ou ao�ecF <br />8• Estimzted Date Eor Camplecian of the °roposed Action: <br />Z'��_ pE�3r.1�7S 6 Crc,,.-n�n.. .,. <br />CoMp. Md,O�i �cicTE <br />. . �EMGI IJ I7E2 <br />,101� , <br />��u�ItiG- pU =LO�A.CJ�..c�. <br />J <br />'1 <br />, <br />J <br />