1404 80TH ST SW 2016-01-01 MF Import

ENVIRONMENTAL CHECKLIST Introduction: The State Environmental Policy Act of 1971, Chapter 43.21C , RCW, requires all state and local governmental agencies to consider environmental values both for their own actions 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 of this checklist is to help the agencies involved determine whether or not a proposal is such a major action. t Please answer the following questions as completely as you can with the information presently available to you. Where explanations of your answers are required, or where you believe an c:cplanation would be helpful to government decision makers, include your explanation in the spac: provided, or use additional pagee if necessary. You shoulc include references to any reports or studies of which you are aware and which are relevant to the answers you provide. Complete answers to these questions now will help all agencies involved with your proposal to undertake the required environmental review without unnecessary delay. The following questions apply to your total proposal, not just to the license for which you are currently applying or the proposal for which approval is sought. Your answers should include the impacts which will be caused by your proposal when it is completed, even though completion may not occur until Fumetime in the future. This will allow all of the agencies which wilt be involved to complete their environmental review now , without duplicating paperwork in the future. NOTE: This is a standard form being used by all state and local agencies in the State of Washington for various types of proposals. Many of the questions may not apply to your proposal. If a question does not apply, just answer it "no" and continue on to the next question. ENVIRONMENTAL CHECKLIST FORM I. BACKGROUND 1. Name of Proponent Rohert Wright _ 2. Address and Phone Number of Proponent- 10204 21st Ave. 355 5569 3. Date Checklist SubI.ritted Marcb_29. 1976 i