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1305 W CASINO RD 2016-01-01 MF Import
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1305 W CASINO RD 2016-01-01 MF Import
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Last modified
1/25/2017 4:15:30 AM
Creation date
1/25/2017 4:14:25 AM
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Template:
Address Document
Street Name
W CASINO RD
Street Number
1305
Imported From Microfiche
Yes
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. . � Ycs st,�b_ � R,•. <br /> .— — • <br /> (19) Rer.rca[Son. Wtl.l thc preposal result in an irpact upon the qua11[y <br /> or quantity of exi,[InE; recreational oppor[uni[ies? _ �_ _ <br /> Explana[ion: _ _ <br /> (2C�) Archeolo�tcal/Nis[orical.. 41111 the proposal resul[ in an alteration <br /> of a signiEican[ atcheological or historLcal site, s[ructure, object <br /> or building? . — Y <br /> Explana[ion: <br /> III. SIGNATUF?E <br /> I, the undersigm�d, state [hat co the bes[ of my knowledEe the abovz iafc:nati_� is <br /> true and comple[e. It is unders�ood [hat the lead agency nay withdraw any declaration cc aon- <br /> siqnificance [hat it migti[ issue in reliance upcn this checklist should there 6e ao.r mis:eprese:- <br /> tatioa or lac.l• of full disclo.�ure on ay part. ��d,� �G���� ,eiiGf/C�/O <br /> �i� <br /> Y:oponent• � °l �. Z�C%�' ' ' <br /> IV. D6CLARATION OF RESPOtiSIBLE OFFICIAL: <br /> The above described nrojec[ is a maio` actio❑ :rith (significan[, insig�iiieant) <br /> impac[ and (w-iI1, will no[) tequire an cnvirorr.ntal Iv:pact State�ent. <br /> . Res�onsible Official <br />
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