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CITY OF. <br />DB V' <br />WASHINGTON Planning, Building, and Community Department <br />ENVIRONMENTAL CHECKLIST <br />1. Name of proposed project, if applicable: <br />2. Name of Applicant: <br />3. Address and phone number of applicant and contact person: <br />Applicant: Agent (if applicable): <br />4. Date checklist prepared: <br />5. Agency requesting checklist: <br />6. Proposed timing or schedule (including phasing, if applicable): <br />7. Do you have any plans for future additions, expansion, or further activity related <br />to or connected with this proposal? If yes, explain. <br />8. List any environmental information you know about that has been prepared, or <br />will be prepared, directly related to this proposal. <br />9. Do you know whether applications are pending for governmental approvals of <br />other proposals directly affecting the property covered by your proposal? If yes, <br />explain. <br />10. List any government approvals or permits that will be needed for your proposal, if <br />known. <br />11. Give a brief, complete description of your proposal, including the proposed uses <br />and the size of the project and site. There are several questions later in this <br />ENVIRONMENTAL CHECKLIST Page I of 13