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ENVIR0:7t11:t�TAL CIII:CF:LIS7' <br /> Less tl:an $1,000,000 �aluc - $50 • <br /> . $1,000,000 value or more - $100 <br /> Introductinn: The StaCe Enviro�imen[al Policy Act of 1971, Chapter 43.27C, kCI•!, requires all <br /> state and J.ocal �overnmental agencies [o consider environmental val�es both Cor their own <br /> netions and tihen licensin� priva[e proposals. The Ac[ also �requires tl:at an EIS be prepared <br /> for all m�.jor acti.ons sigrdficantly aEfectinF; the quality of the environmenC. Ttie puc•pose <br /> of this chec'r.list is to help the a�encies involved determine whether or not a pr.oposal is such <br /> a major action. <br /> F'lease answer the folloe:ing qeest�ons as completely as you can wiCh the information presenCly <br /> a•�ailablc to you. ?.9�ere cr.plcnations of your answers arc required, or where you bclieve an <br /> explanation iaould be hcl.pful to government decision maF:ers, i-nclude your explanaCion in the <br /> spac=_ provided, or use addi.tional pa�es ii necessary. You should include references to any <br /> zeporCs or studi.es of which you are aeoare and which are relevant to the answers you provide. <br /> Complete ansv.ers to [hese quee;tinns now wi11 help all agencie> involved kith your proposal <br /> Lo undertake the required environ�aental review wiChout unnecessary delay. <br /> The following questions apply .o your total proposal, not just to the license for vhich you <br /> are currently applyin� or the proposal for iahich approval is sought. Your answers should <br /> include Che i;apacts which wiil be caused by your proposal wl�en it is completed, e��en though <br /> completion may not occur until so�etine in the future. 'fhis will allow all. oE che agencies <br /> which will. be involved to coc�plete their enviromnental revie�a now, o;ithout duplicating <br /> paper work in the future. <br /> NOTF.: This 3s a standard form beino used by all state. and local agencies in the State of <br /> 47ashington for various types of proposals. Tfany of thc qucstions ray not apply to your propcsal. <br /> qr If a question does not apply, just answer it "no" anc continue on to [he next question. <br /> ENVZ�Or'PicidTAl. Ck1ECi:LIST FORhf , <br /> 1. BACKGROUP;D <br /> 1. Name of Proponent �—'��l�''r%' L ��t/c�'r� -- <br /> 2. Address and Phone Nusber of Proponent: !OZ/�-/ /K�e��J=% �J/c-�v �f' � EuE2F;T� � <br /> F: <br /> 9szo�,� 3s��ozs� ��.3 i� �, � - � �: <br /> 3. Date Cl�ecklist Submitted /� ' � % a �� <br /> 4. Agency Yequiring Checklist <br /> S. Name of Proposal, if applicable: '� r <br /> H '- <br /> H i- <br /> � C: <br /> 6. Nature and Briet Descriotion of the Froposal (i.nclucling but not limieed to its size, ` <br /> general design elements, and other factors tha�c will give an accurate understanding � �` <br /> oE its scope and nature) : ZO .-c�i�r ���r. Sir�� 'L sT��2�/ ' 4�-� h'tirnr9�-tl'_ � r <br /> L D'�' r�i2 �[- %J: .�(�1 FT t�r:� ({nii _ �y F <br /> ' lTj <br /> � <br /> • 7. Localion of Pro;oszl (describe the ph,sical setting of the proposal, as well as the c ' <br /> extent of the land area affected 6y .:ny envizomicn[al impacts, includin� any other � � i <br /> intorma[ion needed [o give an accurate undcrstauding of the environmental settir.g of � � <br /> the proposal) : =o-� �00 - .�G S � L�uE c. w� i fl Si_o P� i o �,,�E t o . <br /> I�cq� CF c�- !_.o�� � I � '; <br /> 8. EsCimated Date for Comple[ion of the Froposed Action: �«� • �4 � � ( <br /> - � � ' <br /> , <br /> � � . : <br /> � I ' <br />