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. , � <br /> Y_e Maybe '% <br /> ' • , Recreation. Wl11 the proposal result in an impact upon the quality • <br /> (19� p ortunitles4 — �' <br /> or quencity of existing reereacional o p <br /> Explanatiun: <br /> � object ' <br /> (2p) prc}ieolooical/Historicsl. Will the ptoposal result in an alteration x <br /> of a s�gnificant archeolugical or historical site structure, -- <br /> or building4 <br /> Explanation: <br /> � <br /> III, SIGNATUkE <br /> I. the undersigned, state that to the best of my knowledge the 8bdeclarat ontofnnon= <br /> [rue and complete. It ia underatood that the lead agency ciay withdraw anY <br /> tationiornlack of fullidiscloaureionrmyipart,upoit this checklist ahould there be any misrepresen- <br /> �� •. ,�y .... • C . � <br /> Proponene: 1i N�*��- r-I•5��• � <br /> . y�c'r�..i't\ �• `�]�L•— <br /> Iy, DE"LAR.4TION OF RESPONSIBLE OFFICIAI.: <br /> The abwe described puirecaniEnviranmentaliImpac[hStatement ant, insignificant) <br /> impact and (aill, will not) req <br /> , � <br /> Responsible Official ' <br /> ' I <br /> c , ,. <br /> I <br /> I � <br /> � <br /> � <br /> � <br /> � <br /> � <br />