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HomeMy WebLinkAboutECF_SEPA_Checklist_20170505_v1DEVELOPMENTSERVICESDIVISIONENVIRONMENTALCHECKLISTCityofRentonDevelopmentServicesDivision1055SouthGradyWay,Renton,WA98057Phone:425-430-7200Fax:425-430-7231PURPOSEOFCHECKLIST:TheStateEnvironmentalPolicyAct(SEPA),Chapter43.21CRCW,requiresallgovernmentalagenciestoconsidertheenvironmentalimpactsofaproposalbeforemakingdecisions.AnEnvironmentalImpactStatementfEIS)mustbepreparedforallproposalswithprobablesignificantadverseimpactsonthequalityoftheenvironment.Thepurposeofthischecklististoprovideinformationtohelpyouandtheagencyidentifyimpactsfromyourproposal(andtoreduceoravoidimpactsfromtheproposal,ifitcanbedone)andtohelptheagencydecidewhetheranElSisrequired.INSTRUCTIONSFORAPPLICANTS:Thisenvironmentalchecklistasksyoutodescribesomebasicinformationaboutyourproposal.Governmentalagenciesusethischecklisttodeterminewhethertheenvironmentalimpactsofyourproposalaresignificant,requiringpreparationofanEIS.Answerthequestionsbriefly,withthemostpreciseinformationknown,orgivethebestdescriptionyoucan.Youmustanswereachquestionaccuratelyandcarefully,tothebestofyourknowledge.Inmostcases,youshouldbeabletoanswerthequestionsfromyourownobservationsorprojectplanswithouttheneedtohireexperts.Ifyoureallydonotknowtheanswer,orifaquestiondoesnotapplytoyourproposal,write‘donotknow’or‘doesnotapply’.Completeanswerstothequestionsnowmayavoidunnecessarydelayslater.Somequestionsaskaboutgovernmentalregulations,suchaszoning,shoreline,andlandmarkdesignations.Answerthesequestionsifyoucan.Ifyouhaveproblems,thegovernmentalagenciescanassistyou.Thechecklistquestionsapplytoallpartsofyourproposal,evenifyouplantodothemoveraperiodoftimeorondifferentparcelsofland.Attachanyadditionalinformationthatwillhelpdescribeyourproposaloritsenvironmentaleffects.Theagencytowhichyousubmitthischecklistmayaskyoutoexplainyouranswersorprovideadditionalinformationreasonablyrelatedtodeterminingiftheremaybesignificantadverseimpact.USEOFCHECKLISTFORNONPROJECTPROPOSALS:Completethischecklistfornon-projectproposals,eventhoughquestionsmaybeanswered“doesnotapply.”INADDITION,completetheSUPPLEMENTALSHEETFORNONPROJECTACTIONS(partD).Fornon-projectactionsfactionsinvolvingdecisionsonpolicies,plansandprograms),thereferencesinthechecklisttothewords“project,”“applicant,”and“propertyorsite”shouldbereadas“proposal,”“proposer,”and“affectedgeographicarea,”respectively.H:\CED\Planning\Annexations\CurrentAnnexations\TimD\Zoning\SEPAChecklist.doc A.BACKGROUND1.Nameofproposedproject,ifapplicable:TimD.AnnexationPrezone2.Nameofapplicant:CityofRenton3.Addressandphonenumberofapplicantandcontactperson:DepartmentofCommunity&EconomicDevelopmentthRentonCityHaIl,6Floor1055SouthGradyWayRenton,WA98057Contact:ChipVincentPhone:425.430.65884.Datechecklistprepared:March28,20175.Agencyrequestingchecklist:CityofRenton6.Proposedtimingorschedule(includingphasing,ifapplicable):N/A,non-projectaction7.Doyouhaveanyplansforfutureadditions,expansion,orfurtheractivityrelatedtoorconnectedwiththisproposal?Ifyes,explain.N/A,non-projectaction8.Listanyenvironmentalinformationyouknowaboutthathasbeenprepared,orwillbeprepared,directlyrelatedtothisproposal.N/A,non-projectaction9.Doyouknowwhetherapplicationsarependingforgovernmentalapprovalsofotherproposalsdirectlyaffectingthepropertycoveredbyyourproposal?Ifyes,explain.No.10.Listanygovernmentalapprovalsorpermitsthatwillbeneededforyourproposal,ifknown.CityCouncilmustapprovetheannexationandzoning.11.Givebrief,completedescriptionofyourproposal,includingtheproposedusesandthesizeoftheprojectandsite.Thisnon-projectactionincludeszoningapproximately2.7acresinRenton’sPotentialAnnexationArea.Thesiteiscurrentlybeingconsideredforannexationusingthe60%DirectPetitionmethod.UnderRCW2 43.21.C.222annexationsorespecificallyexemptedfromSEPA.RCW35.A.14.330-340providesforzoningannexationareas.12.Locationoftheproposal.Givesufficientinformationforapersontounderstandthepreciselocationofyourproposedproject,includingastreetaddress,ifany,andsection,township,andrangeifknown.Ifaproposalwouldoccuroverarangeofarea,providetherangeorboundariesofthesite(s).Providealegaldescription,siteplan,vicinitymap,andtopographicmap,ifreasonablyavailable.Whileyoushouldsubmitanyplansrequiredbytheagency,youarenotrequiredtoduplicatemapsordetailedplanssubmittedwithanypermitapplicationsrelatedtothischecklist.TheproposedTimD.AnnexationisgenerallylocatedatthenorthernportionoftheCitylimitsintheHighlandsCommunityPlanningArea.ItisborderedtothesouthparcellineslocatednearMonroeCt.NE,byparcellinesinproximitytoNE26thc,parcellinestotheeastinproximitytoAveSE,andtothewestbyparcellinesinproximityto122AveSE.TheareaisborderedbyexistingCitylimitsatitssouthernandwesternboundary.ItislocatedintheNorthwesternportionofSection4,Township23N,Range5.B.ENVIRONMENTALELEMENTS1.EARTHa.Generaldescriptionofthesite(circleone);flat,rolling,hilly,steepslopes,mountainous,otherTheareaishasanareaapproximately.22acresinsizeofsteepslopes.b.Whatisthesteepestslopeonthesite(approximatepercentslope?)Thetopographydescendsfromthesouthernportiontothenorthernportionoftheareawithregulatedslopes(greaterthan40%grade)locatedatitsnortheasternboundary.c.Whatgeneraltypesofsoilsarefoundonthesite(forexample,clay,sand,gravel,peat,muck)?Ifyouknowtheclassificationofagriculturalsoils,specifythemandnoteanyprimefarmland.N/A,non-projectactiond.Aretheresurfaceindicationsorhistoryofunstablesoilsintheimmediatevicinity?Ifso,describe.No.e.Describethepurpose,type,andapproximatequantitiesofanyfillingorgradingproposed.Indicatesourceoffill.N/A,non-projectactionf.Coulderosionoccurasaresultofclearing,construction,oruse?Ifso,generallydescribe.N/A,non-projectactiong.Aboutwhatpercentofthesitewillbecoveredwithimpervioussurfacesafterprojectconstruction(forexample,asphaltorbuildings)?N/A,non-projectactionh.Proposedmeasurestoreduceorcontrolerosion,orotherimpactstotheearth,ifany:3 N/A,non-projectaction2.AIRa.Whattypesofemissionstotheairwouldresultfromtheproposal(i.e.,dust,automobile,odors,industrialwoodsmoke)duringconstructionandwhentheprojectiscompleted?Ifany,generallydescribeandgiveapproximatequantitiesifknown.N/A,non-projectactionb.Arethereanyoff-sitesourcesofemissionorodorthatmayaffectyourproposal?Ifso,generallydescribe.N/A,non-projectactionc.Proposedmeasurestoreduceorcontrolemissionsorotherimpactstoair,ifany:N/A,non-projectaction3.WATERa.SurfaceWater:1)Isthereanysurfacewaterbodyonorintheimmediatevicinityofthesite(includingyear-roundandseasonalstreams,saltwater,lakes,ponds,andwetlands)?Ifyes,describetypeandprovidenames.Ifappropriate,statewhatstreamorriveritflowsinto.HoneyCreekislocatedapproximately675feettothesouthwestofthesite.HoneyCreekflowsintoMayCreek.Thereisapossiblewetlandlocatedapproximately1,400feettotheeastofthesiteatSierraHeightsElementarySchooL2)Willtheprojectrequireanyworkover,in,oradjacentto(within200feet)thedescribedwaters?Ifyes,pleasedescribeandattachavailableplans.N/A,non-projectaction3)Estimatetheamountoffillanddredgematerialthatwouldbeplacedinorremovedfromsurfacewaterorwetlandsandindicatetheareaofthesitethatwouldbeaffected.Indicatethesourceoffillmaterial.N/A,non-projectaction4)Willtheproposalrequiresurfacewaterwithdrawalsordiversions?Givegeneraldescription,purpose,andapproximatequantitiesifknown.N/A,non-projectaction5)Doestheproposalliewithina100-yearfloodplain?Ifso,notelocationonthesiteplan.No.6)Doestheproposalinvolveanydischargesofwastematerialstosurfacewaters?Ifso,describethetypeofwasteandanticipatedvolumeofdischarge.4 N/A,non-projectactionb.GroundWater:1)Willgroundwaterbewithdrawn,orwillwaterbedischargedtogroundwater?Givegeneraldescription,purpose,andapproximatequantitiesifknown.N/A,non-projectaction2)Describewastematerialthatwillbedischargedintothegroundfromseptictanksorothersources,ifany(forexample:Domesticsewage;industrial,containingthefollowingchemicals...;agricultural;etc.).Describethegeneralsizeofthesystem,thenumberofsuchsystems,thenumberofhousestobeserved(ifapplicable),orthenumberofanimalsorhumansthesystem(s)areexpectedtoserve.N/A,non-projectactionc.WaterRunoff(includingstormwater):1)Describethesourceofrunoff(includingstormwater)andmethodofcollectionanddisposal,ifany(includequantities,ifknown).Wherewillthiswaterflow?Willthiswaterflowintootherwaters,Ifso,describe.N/A,non-projectaction.FutureapplicationsfordevelopmentintheCitywillneedtocomplywiththeCityadoptedSurfaceWaterDesignManualandtheflowcontrolstandardtobeappliedtonewconstructionintheareaistheFlowControlDurationstandardmatchingForestedSiteConditions.2)Couldwastematerialentergroundorsurfacewaters?Ifso,generallydescribe.N/A,non-projectactiond.Proposedmeasurestoreduceorcontrolsurface,ground,andrunoffwaterimpacts,ifany:N/A,non-projectaction4.PLANTSa.Checkorcircletypesofvegetationfoundonthesite:deciduoustree:alder,maple,aspen,otherevergreentree:fir,cedar,pine,othershrubsgrasspasturecroporgrainwetsoilplants:cattail,buttercup,bulirush,skunkcabbage,otherwaterplants:waterlily,eelgrass,milfoil,otherothertypesofvegetationN/A,non-projectactionb.Whatkindandamountofvegetationwillberemovedoraltered?N/A,non-projectaction5 c.Listthreatenedorendangeredspeciesknowntobeonornearthesite.None.d.Proposedlandscaping,useofnativeplants,orothermeasurestopreserveorenhancevegetationonthesite,ifany:N/A,non-projectaction5.ANIMALSa.Circleanybirdsandanimalswhichhavebeenobservedonornearthesiteorareknowntobeonornearthesite:Birds:heron,____________________Mammals:earelk,beaver,other_______________________Fish:bass,salmon,rring,shellfish,otherb.Listanythreatenedorendangeredspeciesknowntobeonornearthesite.None.c.Isthesitepartofamigrationroute?Ifso,explainNo.d.Proposedmeasurestopreserveorenhancewildlife,ifany:N/A,non-projectaction6.ENERGYANDNATURALRESOURCESa.Whatkindsofenergy(electric,naturalgas,oil,woodstove,solar)willbeusedtomeetthecompletedproject’senergyneeds?Describewhetheritwillbeusedforheating,manufacturing,etc.N/A,non-projectactionb.Wouldyourprojectaffectthepotentialuseofsolarenergybyadjacentproperties?Ifso,generallydescribe.N/A,non-projectactionc.Whatkindsofenergyconservationfeaturesareincludedintheplansofthisproposal?Listotherproposedmeasurestoreduceorcontrolenergyimpacts,ifany:N/A,non-projectaction7.ENVIRONMENTALHEALTHa.Arethereanyenvironmentalhealthhazards,includingexposuretotoxicchemicals,riskoffireandexplosion,spill,orhazardouswaste,thatcouldoccurasaresultofthisproposal?Ifso,describe.6 N/A,non-projectaction1)Describespecialemergencyservicesthatmightberequired.N/A,non-projectaction2)Proposedmeasurestoreduceorcontrolenvironmentalhealthhazards,ifany:N/A,non-projectactionb.Noise1)Whattypesofnoiseexistintheareawhichmayaffectyourproject(forexample:traffic,equipment,operation,other)?N/A,non-projectaction2)Whattypesandlevelsofnoisewouldbecreatedbyorassociatedwiththeprojectonashort-termoralong-termbasis(forexample:traffic,construction,operation,other)?Indicatewhathoursnoisewouldcomefromthesite.N/A,non-projectaction3)Proposedmeasurestoreduceorcontrolnoiseimpacts,ifany:N/A,non-projectaction8.LANDANDSHORELINEUSEa.Whatisthecurrentuseofthesiteandadjacentproperties?Thecurrentuseofthisareaisadetachedsingle-familyresidenceandadjacentpropertiesaresinglefamilyresidences.b.Hasthesitebeenusedforagriculture?Ifso,describe.N/A,non-projectactionc.Describeanystructuresonthesite.Thereisonedetachedsingle-familyresidenceonthissiteandassociatedaccessorybuildings/garages.U.Willanystructuresbedemolished?Ifso,what?N/A,non-projectactione.Whatisthecurrentzoningclassificationofthesite?KingCounty,R-4,4unitspergrossacref.Whatisthecurrentcomprehensiveplandesignationofthesite?KingCounty-UrbanResidential4-12unitsperacre.Renton-ResidentialLowDensity.7 g.Ifapplicable,whatisthecurrentshorelinemasterprogramdesignationofthesite?N/A,non-projectactionh.Hasanypartofthesitebeenclassifiedasanenvironmentallysensitivearea?Ifso,specify.N/A,non-projectactionApproximatelyhowmanypeoplewouldresideorworkinthecompletedproject?Thisisanon-projectaction.Currently,1dwellingunitiswithintheannexationareaandtheestimatedpopulationis3residents.Thereisanestimatedcapacityfor7additionalsingle-familyunitsundertheproposedR-4zoningconditions.Thetotalestimatedpopulationfortheareaat10-yearbuildoutis22.j.Approximatelyhowmanypeoplewouldthecompletedprojectdisplace?N/A,non-projectactionk.Proposedmeasurestoavoidorreducedisplacementimpacts,ifany:N/A,non-projectactionProposedmeasurestoensuretheproposaliscompatiblewithexistingandprojectedlandusesandplans,ifany:Theproposedzoninghelpsensuretheproposaliscompatiblewithexistingandprojectedlandusesandplans,ifany.9.HOUSINGa.Approximatelyhowmanyunitswouldbeprovided,ifany?Indicatewhetherhigh,middle,orlow-incomehousing.Thisisanon-projectaction.Currently,thereis1dwellingunitsinthisarea.Thereisanestimatedcapacityfor7additionalsingle-familyunitsundertheproposedR-4zoningconditions.Itisunknownwhetherthishousingwouldbehigh,middle,orlow-incomehousing.b.Approximatelyhowmanyunits,ifany,wouldbeeliminated?Indicatewhetherhigh,middle,orlow-incomehousing.N/A,non-projectaction.c.Proposedmeasurestoreduceorcontrolhousingimpacts,ifany:N/A,non-projectaction10.AESTHETICSa.Whatisthetallestheightofanyproposedstructure(s),notincludingantennas;whatistheprincipalexteriorbuildingmaterial(s)proposed.N/A,non-projectaction8 b.Whatviewsintheimmediatevicinitywouldbealteredorobstructed?N/A,non-projectactionc.Proposedmeasurestoreduceorcontrolaestheticimpacts,ifany:N/A,non-projectaction11.LIGHTANDGLAREa.Whattypeoflightorglarewilltheproposalproduce?Whattimeofdaywoulditmainlyoccur?N/A,non-projectactionb.Couldlightorglarefromthefinishedprojectbeasafetyhazardorinterferewithviews?N/A,non-projectactionc.Whatexistingoff-sitesourcesoflightorglaremayaffectyourproposal?N/A,non-projectactiond.Proposedmeasurestoreduceorcontrollightandglareimpacts,ifany:N/A,non-projectaction12.RECREATIONa.Whatdesignatedandinformalrecreationalopportunitiesareintheimmediatevicinity?Thisisanon-projectaction.HoneyCreekTrailislocatedapproximately725feetsouthwestofthesite.SierraHeightsPark(anunimprovedgreenspace)islocatedapproximately840feeteastofthesite.HoneyCreekGreenwayislocatedwithin350feetofthesite.b.Wouldtheproposedprojectdisplaceanyexistingrecreationaluses?Ifso,describe.N/A,non-projectactionc.Proposedmeasurestoreduceorcontrolimpactsonrecreation,includingrecreationopportunitiestobeprovidedbytheprojectorapplicant,ifany:N/A,nan-projectaction.FuturedevelopmentwouldberequiredtopayRenton’sParksImpactFee.13.HISTORICANDCULTURALPRESERVATIONa.Arethereanyplacesorobjectslistedon,orproposedfor,nationalstate,orlocalpreservationregistersknowntobeonornexttothesite?Ifso,generallydescribe.N/A,non-projectactionb.Generallydescribeanylandmarksorevidenceofhistoric,archaeological,scientific,orculturalimportanceknowntobeonornexttothesite.N/A,non-projectaction9 C.Proposedmeasurestoreduceorcontrolimpacts,ifany:N/A,non-projectaction14.TRANSPORTATIONa.Identifypublicstreetsandhighwaysservingthesite,anddescriIproposedaccesstotheexistingstreetsystem.Showonsiteplans,ifany.N/A,non-projectaction.AccessisfromMonroeCtNE.b.Issitecurrentlyservedbypublictransit?Ifnot,whatistheapproximatedistancetothenearesttransitstop?N/A,non-projectactionc.Howmanyparkingspaceswouldthecompletedprojecthave?Howmanywouldtheprojecteliminate?N/A,non-projectactiond.Willtheproposalrequireanynewtoadsorstreets,orimprovementstoexistingroadsorstreets,notincludingdriveways?Ifso,generallydescribe(indicatewhetherpublicorprivate?N/A,non-projectaction.FuturedevelopmentmustcomplywithRenton’sDevelopmentRegulations.e.Willtheprojectuse(oroccurintheimmediatevicinityof)water,rail,orairtransportation?Ifso,generallydescribe.N/A,non-projectactionf.Howmanyvehiculartripsperdaywouldbegeneratedbythecompletedproject?Ifknown,indicatewhenpeakvolumeswouldoccur.N/A,non-projectactiong.Proposedmeasurestoreduceorcontroltransportationimpacts,ifany:N/A,non-projectaction.FuturedevelopmentwillberequiredtopaytheCity’stransportationimpactfee.15.PUBLICSERVICESa.Wouldtheprojectresultinanincreasedneedforpublicservices(forexample:fireprotection,policeprotection,healthcare,schools,other)?Ifso,generallydescribe.N/A,non-projectaction.Futuredevelopmentwillberequitedtopayschoolandfireimpactfees.b.Proposedmeasurestoreduceorcontroldirectimpactsonpublicservices,ifany.N/A,non-projectaction16.UTILITIES10 a.Circleutilitiescurrentlyavailableatthesite:electricity,naturalgas,water,refuseservice,telephone,sanitarysewer,septicsystem,other.N/A,non-projectactionb.Describetheutilitiesthatareproposedfortheproject,theutilityprovidingtheservice,andthegeneralconstructionactivitiesonthesiteorintheimmediatevicinitywhichmightbeneeded.N/A,non-projectactionC.SIGNATUREI,theundersigned,statethattothebestofmyknowledgetheaboveinformationistrueandcomplete.Itisunderstoodthattheleadagencymaywithdrawanydeclarationofnon-significancethatitmightissueinrelianceuponthischecklistshouldtherebeanywillfulmisrepresentationorwillfullackoffulldisclosureNamePrinted:C.E.“Chip”VincentforCityofRentonDate:________________________11 D.SUPPI.EMENTALSHEETSFORNONPROJECTACTIONS(Thesesheetsshouldonlybeusedforactionsinvolvingdecisionsonpolicies,plansandprograms.Youdonotneedtofilloutthesesheetsforprojectactions.)Becausethesequestionsareverygeneral,itmaybehelpfultoreadtheminconjunctionwiththelistoftheelementsoftheenvironment.Whenansweringthesequestions,beawareoftheextenttheproposal,orthetypesofactivitieslikelytoresultfromtheproposal,wouldaffecttheitematagreaterintensityoratafasterratethaniftheproposalwerenotimplemented.Respondbrieflyandingeneralterms.1.Howwouldtheproposalbelikelytoincreasedischargetowater;emissionstoair;production,storage,orreleaseoftoxicorhazardoussubstances;orproductionofnoise?Itisunlikelythattheproposalwouldhaveanyaffectontheaboveenvironmentalissues.Additionalresidentialdevelopmentislikelytooccuronthissitewithorwithouttheproposal.UndertheproposedRentonzoningfulldevelopmentofthesitewouldresultcomparableresidentialunitsasispossibleunderthecurrentKingCountyzoning.Proposedmeasurestoavoidorreducesuchincreasesare:Ifnewdevelopmentoccurs,itwillberequiredtocomplywiththeCity’sdevelopmentregulations,suchastheCitly’sSurfaceWaterDesignManual.2.Howwouldtheproposalbelikelytoaffectplants,animals,fish,ormarinelife?Therewouldbenoaffectonplants,animals,fish,ormarinelifeasadirectconsequenceofthisnon-projectzoningproposal.Theremaybesomedisplacementofexistingvegetationtoclearundevelopedlotsforfuturedevelopment,whichislikelytooccurundertheboththepresentconditionsandtheproposal.Proposedmeasurestoprotectorconserveplants,animals,fish,ormarinelifeare:Noneatthisnon-projectlevel.DevelopmentofadditionaldwellingunitsmustcomplywithCityofRentonregulationsandwithRenton’sCriticalAreasOrdinance.Anymeasuresneededinthisregardwillbeimplementedattheprojectlevelreview.3.Howwouldtheproposalbelikelytodepleteenergyornaturalresources?Theproposednon-projectactionwillnotdepleteenergyornaturalresources.Futureprojectleveldevelopmentmayimpactenergyornaturalresourcesslightlybutwillnotdepletethem.Proposedmeasurestoprotectorconserveenergyandnaturalresourcesare:Noneareproposedatthisnon-projectactionstage.4.Howwouldtheproposalbelikelytouseoraffectenvironmentallysensitiveareasorareasdesignated(oreligibleorunderstudy)forgovernmentalprotection;suchasparks,wilderness,wildandscenicrivers,threatenedorendangeredspecieshabitat,historicorculturalsites,wetlands,floodplains,orprimefarmlands?ThisproposaltodesignatetheareawithCityofRentonzoningdoesnotuseoreffectenvironmentallysensitiveareas.Ifdevelopmentoccursinthefuture,itwillberequiredtocomplywithCityofRentoncriticalareasregulationsanddevelopmentstandardsthataredesignedtoprotectenvironmentallysensitiveareas.Proposedmeasurestoprotectsuchresourcesortoavoidorreduceimpactsare:Cityregulationsandrequirementswillworktoavoidand/orreduceimpacts.5.Howwouldtheproposalbelikelytoaffectlandandshorelineuse,includingwhetheritwouldalloworencouragelandorshorelineusesincompatiblewithexistingplans?12 4.TheproposedzoningofthisareawillincreasecompatibilitywiththesurroundingusessinceitwouldrequirefuturedevelopmenttocomplywithCityofRentondevelopmentregulations.Proposedmeasurestoavoidorreduceshorelineandlanduseimpactsare:None.6.Howwouldtheproposalbelikelytoincreasedemandsontransportationorpublicservicesandutilities?Developmentinthisareaislikelytooccurwithorwithoutthispre-zoning.Additionaldemandsoftransportationthatmaybecreatedbynewdevelopmentwillbeevaluatedatthetimeofaprojectproposal.Proposedmeasurestoreduceorrespondtosuchdemand(s)are:None.7.Identify,ifpossible,whethertheproposalmayconflictwithlocal,state,orfederallawsorrequirementsfortheprotectionoftheenvironment.Theproposalwillnotconflictwithlocal,state,orfederallawsorrequirementsforprotectionoftheenvironment.SIGNATUREI,theundersigned,statethattothebestofmyknowledgetheaboveinformationistrueandcomplete.Itisunderstoodthattheleadagencymaywithdrawanydeclarationofnon-significancethatitmightissueinrelianceuponthischecklistshouldtherebeanywillfulmisrepresentationorwillfullackoffulldisclosureonmypart.Proponent:NamePrinted:C.E.“Chip”VincentforCityofRentonDate:_____________________13 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