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i <br />4. Agency Requiring Checklist <br />cable/>li <br />s. Name of Proposal, if a PI i t4,l <br />ut <br />6. Nature and Brief Dc general design elements, Proposaltior/o the and other factors <br />torsot <br />limited to its size, g <br />that will give an accurate understanding of its scope and <br />nature): 7: / <br />7, Location of Proposal (describe the physical setting of the <br />proposal, as well as the extent of the land er area <br />ainfoffected <br />by any <br />needed <br />environmental impacts, including any <br />to give an accurate understanding of the en,, ionmental setting <br />r <br />of the proposal): r,r ' -, _ <br />f% <br />lotion of the Proposed Action: <br />S. Estimated Date for Comp / <br />is Approvals Require <br />g , List of all Permits , Licenses or Goy ernment A p <br />for the Proposal (federal, state ''and local—, including rezones): <br />10. Do you have any plans for future additions, expansion, or <br />further activity related to or connected with this proposal? If <br />yes, explain: A <br />11 Do you know of any plans by others which may affec< LIM <br />property covered by your proposal? If yes, explain: <br />h <br />12. Attach any other application form that has been l <br />leted,lbut is <br />regarding the proposal; if none has been comp <br />expected to be filed at some future date, describe the nature <br />of such application form: <br />