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4. Agency Requiring Checklist _ PlOnni nn I )r n� <br />S. Name of Proposal, if applicable: <br />8. <br />7. <br />Nature and Brief Desrription of'the Proposal (including but not <br />limited to Its size, general design elements, and other factors <br />that will give an accurate understanding of its scope and <br />4 n oq eA Zlla 4e Sj <br />Location bf Proposal (des6fibe the physical §etting of the Up 'to 30 <br />proposal, as well as the extent of the land area affected by any Chi �fCYL I rL <br />environmental impacts, including any other information needed `�Vilen� <br />to give an accurate understanding of the environmental setting reSiaC iyu• <br />1 <br />8. <br />9. List of all Pdrmils , Licenses or Government Approvals Require <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: <br />�N n <br />11 Do you know of any plans by others which may affect the <br />property covered by your proposal? If yes, explain: <br />12. Attach any other application form that has been completed <br />regarding the proposal; if none has been completed, but is <br />expected to be filed at some future date, describe the nature <br />of such application form: <br />