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. , <br /> , . � ' Yea h�bc .bo � <br /> (19) ' Recreation. Will thc propocal result in �n impnct upon thc quality • <br /> , or quantity of, existing zecreational opportunitics? _ _� <br /> Explanatian: • <br /> � <br /> (20) Archeological/Historical. N311 the proposal result in an a].teration <br /> of a signiLicant archcological or historical sitc, structure, obje:ct <br /> or building? � <br /> Explanation: � <br /> . , � <br /> III. SIGNATIJRE � ' <br /> 4' <br /> I� the undersigned, state that to the best of my knowledge the above infozmaCion is I� <br /> [rue and complete. It is understond that the lead agency may withdraw any declaration of non- I � <br /> si.gnificance that it might issue in reliance upon thjs checklist should there be any misrepresen- , <br /> tation or Iacl: of full disclosu�e on my part. ' <br /> Proponent• , <br /> IV. DECLARATION OF RESPONSIBLE OFFICIAL: �2 w�«-�n"1 ��L1L/3 <br /> H I�C. Cv: <br /> The above described pro3ect is a major ac[ion with (significant, insignificant) <br /> impact and (caill, will not) require an Environmental Impact Statement. <br /> . Q��O <br /> �0 ��� �1g,�g Responsible Off .cial <br /> pCj v��'i't . . •� <br /> • C��Ye\p�`$ paP�• � , <br /> . ' <br /> � <br /> �� <br /> , r <br /> � � <br /> . � <br /> � r <br /> � <br />