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- (19} <br />. , • . -- --__. _....— � "' Yes Maybr-,.N�,__ <br />Recreation. WS11 t�.... proposal result !n an impact u�_1 the quallty � �A . Ty <br />or quantity of existing recreational opportunities? J( <br />Explanation: <br />(20) ArcheoloQical/Hiatorical. Will the propoeal result in an alteration <br />of a eignificanc archeological or hiatorical site, structure, object <br />or bu11dingY <br />Explanation <br />III. SICNATIJRE <br />� �_ <br />c: r_ . .. <br />� '. �. �,: : <br />, ", . <br />;�•;�: ,, <br />..,,. <br />,'�:� , <br />I, the undersigned, atate ehat to the best of my knowledge the above inEorution ia <br />teve and complete. It is understood thae tha lead agency may withdrav any declarati.on of non— <br />eiqniEicance that it m7ght issue in reliance upon this checkl3st shnuld thete be any misrepresen— <br />t�tion or lack of full disclosure on my part. <br />Proponent: <br />IV. DECLiR1T.I0N OF RESPOhSIBLE OFFICIAL: <br />The above described project is a major action with (significant, insignificant) <br />impact and (�.ill, vill not) require an Environmental Impact Statement. � <br />Responai.5le Official � <br />0 <br />