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� <br />;• . <br />ENVIRONMENTAL CHECKLIST <br />($� 00 Fee Required) <br />;,f <br />`;i <br />Introduction: The State Environmental Policy Acl of 1971, Chapter 43.21C, RCIi, requirea all <br />state and local governmental agencies to consider environmental values both for their mm <br />actions and vhea Iicensing priva[e proposals. The Act also requires that an EIS be prepared <br />For all ma,jor actions significantly affer_�ting [he quality of the environmeat. The purpose <br />of this checklist is to help the agencies involved determine whether or not << proposal is such <br />a major action. <br />Flease anscaer the following questians as completely as you caa with the information preseatly <br />available to ;�ou. [,There exp].anattons of your anscrers are required, or where you believe an <br />explanation would be helpful to government decision makers, include your explanatioa in the <br />spac� provided, or use additional pages if necessary. You should include references to any <br />reports or studies of which you are aware and which are relevant to the ansarers you provide. <br />Complete answers to these questions now will help all agencies involved with your proposal <br />to un3ertake the required environmental review without unnecessary delay. <br />The follocring ouestions apply to your total proposal, not just to the license for which you <br />are currently applying or the proposal for which approval is souohc. Your ansuers should <br />include the i:apacts which will be caused by your proposal when it is completed, even though <br />cc�pletion may not occur until smnetime in the future. This �rill allow all of the ageacies <br />which will be involved to conplete their environmental reviecr now, without duplicating <br />paper work in the future. <br />1dOTE: This is a standard form being used by all state aad local agencies in the State of <br />4iashington for various types of proposals. Many of the questions nay not apply to your proposal. <br />If a question does not apply, just answer it "no" and continue on to tki� next questian. _ ;l;+ <br />ENVIRO�..t..i'T9I. CHECI�'LIST FORM ,.� •� <br />1. BACKGROUND <br />1. Naae of Proponent 7-"�.�:5 OLSON • <br />. — t� <br />_ ._ _ .�_ <br />2. Address and Phone Number of Proponent: PC 9C% 607� 1:'UKIiTzO� '';N 98275 <br />3. Date Checklist Submitted 4/24� '79 <br />4. Agency Requiring Checklist citv of e:�erett,�lsnni.ne de�t. <br />5. Name of Progosal, if applicable: gpi^; 3�T . pFTS • <br />6. Nature and Brief Description of the Proposal (incicding but not 13.mited to its size, <br />general design elements, and other factors that will give an accurate understanding <br />of its scope and nature): 3Td LI(,�.:T UPtI?' :�FT. HGUS�. CGI?F25TIiIG Or^ �GLZi 'm;C BFDROCt <br />II>:IiS ;1i� rGUF? C\� ?'�7'CQi'. L:�IZ^S, Ci1 '�'':�Q FLC03S i�I'� 4. (,'\'7�pGnOLTi�'D F R fi(' C'R��= <br />: Cn. �IC3iT i0 ?: ��TT Cti.^�S. PLDG. i.ILL �� 35. _'est b-% �y ieet. <br />7. Location of Proposal (describe the physical setting oF the prnposal, as well as `he <br />extent or the land area affected by any environmental impacts, including any other <br />infonatioa needed to give an accurate understsnding oi the ec�vironmental setting of � <br />the proposal): '??� r O=CS�D ?L;G ''-I; L �- ^ ,=;cr ,�,,, ,� :!_w � �;C��r a�T" TT1 "'r""'=_-.�T <br />C:' '=::3 .".. ..CCF.:?�a� X:?C:'�Pi i.= >LQ2 'r.CYT.: `P. �'fiF. �CA?1i1G IS P.-a:'1�+..� •..• °•'-ort'; - <br />...� .s�.,n_1�:,.1. � � r:_.0 � �.• r'aY N�nY�PBSIQ_., lBl, iylL <br />• �.. :.a__' :LJ�. J1a1�L:. t'r.i:.1L_ ..._.. .: �I.�.:. b. �LiIrL�� <br />=i'r�� ' '...... �. _ . <br />8. Estima[ed Date for Completion of [he Proposed Action: `:CTl.i9 <br />