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ENVIRONMENTAL CHECKLIST <br />($25.00 Fee Required) <br />mmm�00 <br />SEP 12 1978 <br />CITY OF EVEREIT <br />Introduction: The State Environmental Policy Act of 1971, Planning wept. <br />Chapter 43.21C, RCN, requires all state and local governmental <br />agencies to consider environmental values both for their own <br />actions and when licensing privcte proposals. The Act nlso <br />requires that an EIS be prepared for all major actinns significar_- <br />affecting the quality of the environment. The purpose of this <br />checklist is to help the agencies involved determine whether or not <br />a proposal is such a major action. <br />Please answer the following questions as completely as you can <br />with the information presently available to you. Where explanations <br />of your answers are required, or where you believe an explanation <br />would be helpful to government decision makers, include your <br />explanation in the space provided, or use additional pages if <br />necessary. You should include references to any reports or studies <br />of which you are aware and which are relevant to the answers you <br />provide. Complete answers to these questions now will help L-1 <br />agencies involved with your proposal to undertake the required <br />environmental review without unnecessary delay. <br />The following questions apply to your total proposal, not just to the <br />license for which you are currently applying or the proposal for <br />which approval is sought. Your answers should include the impacts <br />which will be caused by your proposal when it is completed, even <br />though completion may not occur::ntil som•,time in the future. This <br />will allow all of the agencies which will be involved to complete <br />their envi*onmental review now, without duplicating paperwork in <br />the future. <br />NOTE: This is a standard form being used by all state and local <br />agencies in the State of Washington for various types of proposals. <br />Many of the questions may not apply to your proposal. If a question <br />does not apply, just answer it "no" and continue on to the next <br />question. <br />ENVIRONMENTAL CHECKLIST rOR1i <br />I. BACKGROUND <br />1 <br />2 <br />3. <br />Name of Proponent Mflrshra 6 Rnrllal,+L' <br />Address and Phone Number of Proponent: J <br />