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eae 13 6 2S MO RAT LR A ne UBER gaged pasate ate * Shor’ Environmental Assessnient Form Part » Peajecit Informatiot Lustructions for Conrploting Part i ~ Project Information, The applicant or profeat spottsar ts tespanalble for the completion of Part 1. Reaponses teconse part of the application for approval or finding, are subject to public review, and maybe subject (o furtthar ‘vorification, Goniplete Part 1 based ou isfortnation currently available, [Faddittonal reseucch or invesligaiton would be needed to fully respond fo any Hens, please taswet as thoroughly as possible based on current fiformation, Coraplete all items in Part 1. You may also provide any additional information whieh you believe will be needed by or usefil to the lead agency; atiach additional pages a necessary to supplement any them, Parti ‘Project aad Spou eNO Nante of Action or Bistect: age”Pauy | Vi\lao?e Plow Project Location desoribe, and aflach a location nip): ‘Brief Deserl (a Bostkalo &h cast Porat wy vo of Proposed A tion: 44052. Mose X30 LISSn BUS ws Wess Village sat ape ey (\U, see ray Cun bo onc im oN Quer SCY | ae ioe Name of Applicant of Shonson : “Tolepl Hone: al rea +? (ie Address: lasey Corcrere 05 Saint: st . MIC OSOY@ IVAge Play} con | | City/PO: Easy. Aa) Yo CA - oe . State: WY 2ip at OS 2 Te ir Does the arenased action only involve the iagielatie adoption ofa plan, local law, ordinance, No YES administrative cole, or regulation? IF Yes, sflach a natrative desoription of the intent of the proposed action and the environmetital resouteds that - Cc] a may be affected in the municipality and proceed to Pari 2. [fno, contiriue to question-2, 2. Does the proposed action require a permit, approval or funding from any other, - govertinient Agency? \ | NO | YES if Ves, list agency(s).nante and permit or approval: “1% - 3. a a, Tolal acreage of the site of the proposed =i UIA HONG,LAAP noresPONE” . | ET | OF : b, Total-acreage to be physically disturbed? So acres 6, Total acreage (project site and any contiguous properties) owned or controlled by the applicant or Project sponsor? AA - avies + 4, Cheek al lead tiseg that oveur on, are adjoining or near the proposed action: / s [oJ Dibun Pen (iomagrieutture) [2]: tadustriat Commercial ESsResidenttal (suberban) 7} Forest [2] Agricnlinre EZ] Aquatic [C] Other(Specily)s $2 Parldand Paue | of 3 SEBAF S010