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�� <br /> I ' <br /> , <br /> . v�a M.yhc r,�, . � <br /> (19) Recrentlon. W111 the proposal result in an lmpact upon thr. qunlity <br /> or quanct[y of exl�ting recrentlonal oppor[unities? � ' <br /> i <br /> E;cplanntion: , — -- � <br /> � <br /> (20) Archeolo.(cal/Ili�torical. VlL11 the propasal result in an alteration � ' <br /> of a signiEfcan[ archcological or historlcal site, structure, ob�ect ' <br /> or building? `l <br /> 7S <br /> Explanation: — <br /> • i <br /> i <br /> ' • 1 1 <br /> III. SICNpTURE � <br /> I, the underaigned, atate thnt to the best of my knowledge the above information is <br /> true and complete. It is understood that the lead nEency mny withdraw any declaration o£ non- <br /> eiqniFicance that it mfght issue in reliance upon [his checklist should there be any misrepresen- <br /> tation or lack of full diaclosure on my part. <br /> Proponent• �a� / ���''�N'r'i'"'� • � <br /> IV. DECLARpTION OF RESPONSIBLE OFFICIAL: <br /> The abwe described project ia a major action vith (significant, ineignificant) <br /> impact and (will, will not) require an Environmen[al Impact Statement. <br /> , Reaponeible Official r <br /> ' . V <br /> . . i �_ <br /> ' r' <br /> _' ' � . � I <br /> � . 1 � 1. <br /> ! <br /> I � A� II <br /> • ; ! <br /> . � � <br /> . 4 <br /> � e <br /> r � <br /> � <br /> . . ' I <br /> . � <br /> . 1 � <br /> ' I <br /> I <br /> I <br /> - �J <br />