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4320 COLBY AVE 2016-01-01 MF Import
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4320 COLBY AVE 2016-01-01 MF Import
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Last modified
1/27/2017 3:14:30 PM
Creation date
1/27/2017 3:13:47 PM
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Address Document
Street Name
COLBY AVE
Street Number
4320
Imported From Microfiche
Yes
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�� ��e-�uc--n� <br />.� •�.9) Rccrcatfon. Will the proposal result !n an impact upon [hc quality — _— % <br /> ' or quantity of exiFting recreational oppor[Jnitics? <br />� Explanation: <br />!-I • (20) Ardieological/Historical. Will the propoeal result in an alteration <br />�. oi a significanr archeolosical or historical site, structure, obSect X <br /> o: building? '—' -- <br /> Explanation: � <br />�� ' <br /> r <br />�t <br /> � IlI. SIGNATURE <br /> I, the undersigned, state Chat to the best of•m� knowledge the above infotnation is <br />,' true and complete. It is understood that the lead agency may withdraw any declaration o[ non- <br /> 1i eiqnif'cance that it night 3ssue in reliance upon this checklist should there be anp misrepresen- <br /> - tatior �r lack of full disclosure on my part. • , <br />{� , proponent• � v"L� <br /> IV. DECLf1RATI0N OF RESPONSIBLF. OFFIC7AL: <br />�y The above desciibed project is s major action with (significar�t; insignificant) <br /> , impact and (will, will not) require an Em+ironmental Impact StatemenC. <br /> i, <br /> Responsihle Official <br /> a <br />
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