Laserfiche WebLink
. � • , Yes M�: No� <br />(19) ];c_r.rcatinn. Y1311 thc proposal res;ulC in an impacL• upon chc quallCy � <br />or cuanzit� of c•::istiny :ecreational opportunit9.es? <br />Lr.planaCiun: <br />(20) Arct�col.o�ical/llistorical. Ylill the proposal result in an altcration <br />ot a significant archeological or historical site, strucCure, ob;ect <br />or building? <br />— -7� <br />Explanation• <br />TII. SIGi7ATURE <br />I, the undersigned, state that to tlie best ot my knowledge the above infornation is <br />true and complete. Zt is understood that the lead agency may,c:ithdraea any declara�ion of r,on- <br />significance Chat it might issue in reliance upon this check].ist should there be any c�isrep:esen- <br />tation or lack of fu11 disclosure oa my part. <br />' Proponent: ��.� � ��� <br />�7/,r�.y � <. � .</. =ry � �--._ <br />IV. D�CLhRATION OF RESPONSIBLE OFFICItLT: <br />The above described prciect is a major action �rith (sionificant, insignificant) <br />impact and (crill, taill not) require an �nvironmental Impact State:uent. <br />Responsi6le Ofiicial . <br />