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J <br /> f <br /> ' . . . ' • Yee Maybe No <br /> : , (e) Storm water drainaqe'1 � /� __ <br /> (f) Solid waste and disposal7 _ _ �/ <br /> ' ' Explanation: C�i� ,�7.'+:,9t idME? PEt�.�tnON /`�r-,�'� � <br /> —Gl2L 8= D,CO%<96D . <br /> . {17) Human Health. Will the proposal � � � <br /> , • resu t in thc creation of.any . <br /> . health hazard or potential health . � �� <br /> hazard (excludinq mental health)3 _ _ y <br /> Explanation: � � <br /> ' (2H) Aesthetics. Will the pronosal re- . <br /> � � sa�in the obstruction of any � � <br /> acenic vista or view ouen to the ' <br /> , public, or will the proposal re- • ' <br /> ' _ ault in the creation of an aesihe- , • - <br /> tically offensive site open to ' � <br /> public viev? �►� , <br /> Explanation: UD�v..L alEi!✓+BPA5 AL/:Ltf 97T.E&r MAY //�4VE <br /> v c 81r r Cr��rt 4�•'f_^�t C�Y .Y�:.1�i/�a f/.51�%NT, �/E4J <br /> .l�v�. � . , . - _• T s�o ?,coPs.¢rY. <br /> (19) ecreation. i�I�t.e proposal re- . <br /> suTin an im�act epon the quality • <br /> or quan`_ity of existing reerea- — — � , <br /> . tional opportunities7 � , <br /> Explanatton: � � <br /> . (20) Archeoloqical/Historical. Will the ' • ' <br /> � � ,proposal resul[ in an alteration of � � i <br /> , a �aignificant archeoloqical or his- . ' � <br /> tozical site, structure,. objec[ oc � i <br /> buildinq? . _ ✓ <br /> . £xplanaiion: - � <br /> � i <br /> TII. SZGNATURE � . � <br /> ' I, the undersigned, state that to ihe best�of my knavledge , <br /> � tke above information is true and eomple[e. It is understood that i <br /> ' tha lead aqency may withdraw any declaration of non-signficance j <br /> ' -ihat it might issue in reliance upon this eheckl�ist should there � <br /> be any misrepresentation of lack oE full disclosure� on my part. / � f <br /> Proponent: �aN�fn ANdFR50N F/.'Ei�j/If�/j � <br /> SV. DECLARATION OF RESPONSIBLE OFFICIAL: �'� f'C' -�'n � � <br /> � The above described project is a najor aetion.with � <br /> (aiqnificant,� insianificant) impact and (will, will not) require an i <br /> � 'Enviromnental impact Statement. � • <br /> • ' � . Respo�sible Offieial . . + <br /> 4 <br /> $ <br /> � <br /> � . ^ <br /> ` � �. <br /> � <br /> � • � <br /> . I <br />