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CHECbxl K <br />nra <br />Sep 1' 01 <br />Purpose of Checklist: Ci► + OV QBP�t <br />�nnlne <br />The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all governmental agencies to consider <br />the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be <br />prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of <br />this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce <br />or avoid impacts from the proposal, if it an be done) and to help the agency decide whether an EIS is required. <br />ENVIRONMENTAL <br />Instructions for Applicants: <br />This environmental checklist asks you to describe some basic information about your proposal. Governmental agen. <br />cies use this checklist to determine whether the environmental impacts of your proposal are significant. requiring <br />preparation of an EIS. Answer the questions briefly, with the most precise information known. or give the best de- <br />scription you can. <br />You must answer ezch question accurately and carefully, to the bat of your knowledge. In most cases. you should <br />be able to answer the uuestions from your own observations or project plans without the need to hire experts. If you <br />really do not know the answer, or if a question does not apply to your proposal, write 'do not know' or 'does not ap- <br />ply'. Complete answers to the questions now may avoid unnecessary delays later. <br />Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer <br />these questions if you an. If you have problems, the governmental agencies an assist you. <br />The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time:or on <br />different pawls of land. Attach any additional information that will help describe your proposal or is environmental <br />effects. The agency to which ,you submit this checklist may ask you to explain your answers or provide additional in. <br />formation reasonably related to determining if there may be significant adverse impact <br />Use of checklist for aonproject proposals: <br />Complete this checklist for nonproject proposals. even though questions may be answered 'don not apply.' IN AD- <br />DITION, complete the SUPPLE -MENTAL SHEET FOR NON►ROJECr ACTIONS (part D). <br />For nonproject actions, the references in the checklist to the words 'project.' 'applicant' and 'property or site' <br />should be read as 'proposal,' 'proposer,' and 'affected geographic area,' respectively. <br />A. aAcxcRouNv <br />1. Name of proposed project, if applicable: <br />vAC+wr LAnjo goTW_Enrr To E vasecrr F9M MEnnootsr C/aac.+ , &LOAc.A c- <br />7b Ev"err Mee mEr7,lpour cnwxcµ <br />2. Name of applicant: NV6 S m <br />3. Address and phone number of applicant and contact person: <br />1703 /27ci X. Se f_vf U208 138 -279L <br />COA+Wr DAW_ Own LE" irs64SgCe R-r C-No"M #Us- 548S <br />4. Date checklist prepared: 8 '30-9H <br />5. Agency requesting checklist: SE✓q <br />6. Proposed timing or schedule (including phasing, if applicable): <br />$,q:r sat- 95 <br />7. Do you have any plans for future additions. expansion, or further activity related to or connected with this proposal? <br />If yes. explain. <br />Ivor *r 7746 nmc <br />