3614 SMITH AVE 2016-01-01 MF Import

�— � , LNVIRONIIhTi'f0L CII",CKLLS" ' , ($25.00 Fcr_ Requltcd) Introduc[ton: Thc St�tc Environmental Policy Act oE 1971, Cl�aptcr 4).21C, RCIJ, requires all statc acd locai govcrnmantal :igencics ta considcr enviroumen[al v�lucs bo[h Eor theLr ovn actlons and whrn licensing privatc praposals. Thc Act also requires that an GIS bc prepared Eor all mnjor �ctians signiEicantly afEecting the quality oE [he environment. 'Che purpose of this checklist is to help the aEencies involved determine whether or not a proposal is such a major action. Please answer [he following questions as comple[ely as you cnn with the in£ornation presently available to you. idhere erplanations of your answers arc required, or where you believe an explanation vould be helpful eo govern�enC decision makers, include your e.:planation in [he space provided, or use additional pa�es if necessary. You should include ref�rences to any reports or studies of which you are aWare and crhich are relevant to the ansc:ers yuu provide. Complete ansaer� to these questians now will help all a�encies involved with your p:oposal to undertake. the req��ired environmental revieN with.out unnecessary delay. ` The _'ollowing questions apply to your total proposal, nct just to the license for which you are currently applying or the proposal for �ahich approval is sought. Your answers should include the impacts which will be caused by your proposal when it is completed, even thnugh conpletion may not occur until sometime in the future. This will allow all of the agencics which aili he involved to conplete their environmental tevieia now, without dupiicating ` paper work in the future. • � NOTE: This is a standard form being used by all state and local agencies in the State of , Washington fur various types of proposals. M�ny of the questions may not apply to your proposal. , If a question does not apply, just answer it "no" and continue on to the next question. � Eh'VIRONMErTAL CHECKLIST FORtt 1. BACKGROU2rD �} n f� , / 1. Name oE Proponent ( i �/l�// t�iPal�r T� E s � N C �L UQ C,� 2, l,ddress and Phone Nuciber of Proponent: / 7'�S .S• L�� f��Fl� � Ci/f L/F � � - -s- 3. Date Checklist Submitted '� C� • Z • � �� 4. Agency Requiring Checklist G �T `( C�F � y E '�F TT - 5. Name of Proposal, if applicable: G E � � � E G ��'`�'�u�� , �1 Z DD �' AnD r�'t o�1 - 6. Nature and Brief Description of the Proposal (includinQ but not limited to its si�e, general design elenents, and other factors that will give an accurate undcrstanding of its scope and nature) : �/�L`.50�1E;� �� n��` �-n��STi''1GTi 01� c � v � = i ( O�I - 'I 7. Lo�jo�o�roposal (describe the physical set[ing of the proposal, as wcll as the extent oE the iand area aCEected by an}' environmental impacts, includinr any otlier informa[ion r,ecded to give nn :iccurate understanding of the cnvironmental �etting oE the pro�+osal) : ;'\ D C� 13 � n i.I n t�l '��„T'�-, � 1 �� c Cl � �a , �� XI_--T'�� S �� ,�.� � � 8, Bstlm:�ted Da�c Eor Complc�ton oE thc Proposed Actlon: � Z � � �Y�---1-'�+'-_��- � SSV tilCc= nC DE.t iT � r ,