1304 80TH ST SW 2018-01-02 MF Import

($50.00 Fee Required) • 75- 33 ntroeuction: The State Environmental Policy Act of 1971, Chapter 43.21C, RCW, requires all :Cate and local governmental ageacies to consider environmental values both for their own •etfons and when licensing private proposals. The Act also requires that an EIS be prepared `or all major actions significantly affecting the quality of the environment. The purpose •f this checklist is to help the agencies involved determine whether or not a proposal is such major action. lease answer the following questions as completely as you can with the information presently available to you. Where explanations of your answers are requited, or where you believe an xplanation would be helpful to government decision makers, include your explanation in the pace provided, or use additional pages if necessary. You should include references to any eports or studies of which you are aware and which are relevant to the answers you provide. omplete answers to these questions now will help all agencies involved with your proposal o undertake the required environmental review without unnecessary delay. he following questions apply to your total proposal, not just: to the license for which you re currently applying or the proposal for which approval is sought. Your answers should tclude the impacts which will be caused by your proposal when it is completed, even though impletion may not occur until sometime in the future. This will. allow all of the agencies rich will be involved to complete their environmental review now, without duplicating tper work in the future. YfE: This is a standard form being used by all. state anu local agencies in the State of ashington for various types of proposals. Many of the questions may not apply to your propot;al a question does not apply, just answer it "no" and continue on to the next: question. VIIIRONMENTAL CRECIMIST FORM "BACKGROUND 1. Na .p� D 1. Name of Proponent 2. Address and Phone Number of PQ 'Proponent: y'OX rg� �' e 00�ZO 10 to-14Z 3. Date Checklist Submitted WOVC41�)24' 1 Qi 1'q-lq ^ 4. Agency Requiring Checklist 5. Name of Proposal, if applicable-aj,�---- ��, 1 t e 6. Nature and Brief Description of the Proposal (including but not: limited to its size, general design elements, and other factors that�-_w,}�.i__llI' g a on accurate understand of is scope and nature) :- I5t^CY+ �J47. r—• II�t1-t-� i921 !JJ _ 7. Lncati.on of Proposal (describe the physical setting of the proposal., ns well as the extent of the land area affected by any environmental impacts, including any other informarfon nee ed to give a accurate understanding f the envir numntal. settingof the proposal): ' cq +, T� -;;• I`• 5,2(" hcylk"4<1 .1. tA.fe . 'I cvf� 8. Estimated Date for Completion of the Proposed Action: 4tmy%'1� (�8U • J �