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Yes MaYbe No <br />'' (19) ;2ecreation. W111 the proposal result in aa impact upon the quality <br />or quantity of existing recreat3onal u�portunities? _ �,_ <br />Explanation• <br />(20) Archeological/Historical. Will the proposal result in an alteration <br />of a significant archeolo�ical or historical, site, structure, objecL' <br />or building? ' _ X <br />Explaaation: <br />:II. SIGNATURE <br />I, the undersigned, state that to the best of my knowl.ed�e L'he above in£ormati.on i::_ <br />:rue and complete. It,is understood that the lead agency may wi.t:hdr.aia any declaration of non- <br />;ignificance that it might issue in reliance unon this cliecklist should there be any misrepresen- <br />:ation or lack oE full disclosure on my part. <br />`/ C — �' /// <br />��' <br />Pxoponent: �- �%.� ��-a� <br />• l - <br />IV. DECLARATION OF RESPONSIBLE OFFICIAL: <br />The above de'scribed project is a najor ac[ion with (significant, insignificanL•) <br />impact aad (will, will not) require an Environmenta7. Impaet SCat:ement:. <br />Responsi.ble OFfici.a]. <br />� <br />