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1 <br /> • � . . ' .- <br /> ; • . • <br /> , , <br /> . . ' ' . . . �. ._ . <br /> � 4. Agency Requiring Checklist �,r{ �,e �__`��� � „ �,�6 ��, • <br /> . ' 5. Nume of Proposal, if applicable: ' 1 � <br /> F�L�i�Ci�1!-_ �-' n CT +r+i t-T k �/ �LTikr'�+.JS <br /> ' . 6.� Nuture end Bricf Description of the Proposal (inciuding but not <br /> , • limited to its size, generul design elements, and other factors <br /> ., that will give an accurate undcrstanding of its scope und ' <br /> : , nature): <br /> , . 'j�_�C�rt��ai i-�-, Z-+Vc cwn ivT'icil_GP -3 F�����M T� <br /> . • , ' �IS� � '�: N(: _ uT� :5 r. r � ... _ C i�^ _ � <br /> . . 7. Locntion ef Proposal (describe the physical setting of the <br /> . , proposal, as tvell as the eYtent of the land area atfected by any <br /> . environmental impacts, including any other information needed <br /> ' ' to give rin accurate understanding of Yhe environmental setring � <br /> of the proposal): • . , ' <br /> � �(�'i3'��i � Lt�'v�r� +-1 �f) 1rc' Y� 4br�6.Tf(i?io (��r ,C�.r,(Lad�/, . <br /> . .�[?Z�—�Ia T �: l� �Tll � �1 1 7 / 1'. �c� i�`�'r�V�L''' / F�ILLS • <br /> ��1��ti I f�l 7 F X�ic. hJ .i- -T-.-�-ln 16c r^ 1-�-u ?+ -���,c6, Sa�c h�0 <br /> 8. Estimated llate for Conpletion of the Proposed Action: ��6�'�N <br /> ' IG'� <br /> . • . •9. List of nll Permits, Licenses or Government Approvals Required • <br /> � for the Proposal (federal, state and local= including rezones): • <br /> ' _ • L-zF�Sti�t< �--i�A�T' - G�T� �G r—��1��=^- <br /> 10. Do you have uny plens for future addilions, expansion, or . <br /> , � further uctivitp related to or connected ti•�ith this proposal? If <br /> , yes, expluin: • . , ' • • � <br /> � � _ .L��� i-.12��A{(-. D`��JII.If an�n cr_,.tcW, .�i�� . � <br /> �.U)C <br /> . • , I <br /> , 11 Do you kno•,v of any plans by others tvhich tnny uffect the i <br /> • � property covered by your proposal? If yes, esplai�i: ; <br /> ' �� ' • ' <br /> 12. Attnch any other npplicEtion form Lhnt has been completed , �.:' � <br /> regnrdin� the proposal; if none has been completed, but is • ' <br /> • ea-pected to be filed at some future dafc, describe the nature ' <br /> , of sucti npplication form: � • . � • � <br /> .. . . <br /> � / Itiz'C' �c+l �n�T ,s�'� 1 f ' , . <br /> � . <br /> ' ' • . • "'�;% ' <br /> �. <br />