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. . . � ' Yes May!� � wtlo ' <br />;19) }tecrcati.on. W111 thc ptoposal recult in an impact upon Clic quality <br />or quantil•y aL er.isLing recrcational opportunities? _ X <br />Explanation• <br />(20) Archeolop,ical/Ilisl•orical. 41i11'the proposal result in an alteration <br />of a significanC archeological or historical siCe, structure, object V <br />or building? _ �� <br />Explanation: <br />III. SIGNATURE . f .' <br />� I, the•undersigned, s[ate that to the best of my knowledge the above information is <br />true and cou�plete. It is unders[ood that the lead agency may withdraw any declaration of non- <br />significance thaY it miSht issue in reliance upon this checklist should there be any misrepresen-i <br />tation or lack of full disclosure on my part. <br />Proponent:o <br />• �_,s� �.�.._— �� <br />�: La�Rz-( . l� u1, $ <br />IV.' DECLARATION OF RESPONSIBLE OFFICZAL: � <br />The above described project is a major action with (significant, insignificant) <br />� impact and (will, will not) require an Environmental Impact Statement. <br />Responsible Official <br />� <br />