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)'cs 1�nyl�c No <br /> - . , . . , , .---�- -- - — <br /> (e) Storin t:�atc1: cir.ai�iriyi,? �/ <br /> -- - - =� <br /> (f) So.1i_d ��;a:;t.c t,nd di.:;posal:� / <br /> Ii;::plrin��tion: <br /> ----- -- -�. <br /> (17) llnmrin IIr.a].t:h. 6•2i:l.l. t.h�� proposal --____---- <br /> rc•su:l.t in thc crcaL-i.on of an�� <br /> hca] i:ii hriza,-d or- poten�ia7. herilth �/ <br /> ha:::t�d (e::c].udinc� tncn���.l. hr_ali_h) ? — ---- /_ <br /> . <br /> 1;::1,1<,natiori: <br /> (1G) hcsi:he+�ics . P,�ill {:l�c p��onosal 'ro_ ---------- <br /> sult i.n i:he ob:;trucl-.ion o; any I <br /> sco,n:i.c vi.sL-a or vi.eca open i:o the <br /> pul,l.ic, or tri.11 tLe p�onosal re- <br /> ��uli: i.n the cre�it.5.on of an aesi:he- <br /> ti_cz:1.1_�, �f:f:ensive :.iie open �:o <br /> publ.ic vict•:? --- --- X <br /> P;>:pl'ar�ai:ion : <br /> (19) R�_crcation. 14i.11 {.he proposal rc,_ --- -------- <br /> sn.lt in ��n impact upon the que�;.i.ty <br /> or quantii:y of exi.si:ing recr�a- <br /> i.ion�l cppor.tunit-ies? � LL\ <br /> L>;,�i�;nat�.on: <br /> (20) Arclieolo�7ica1!tii.stori.ca7. . j•;ill Ciie --------- <br /> pi:opo;al iccult S.n�zn aiteration of <br /> a si.gni.ficant archeoiogical or. liir- <br /> tor.ical site, structure, object or <br /> bt�:ildS.iig? -- -- �\ <br /> L::�:anati.on: <br /> III. SIGI�71'J'UkE <br /> I, the undersigned, state that to t17^ best of my };�i��;;].edc��� <br /> t1�e above S.nforraation is true anct co?op.l.ete. Tt is unde�-si:ood that <br /> ih� lead aqcncy mt�y ta.i.t:l�dr.a�o any decl�u:aCion of non-signfi.cance <br /> t1�:;: ii. �n.i ��lit i�:sue iri reli.�u�ce upon ti�is chec};lisi_ sliou].d therc <br /> l.�e .:ny nu.srcprc.;�nt.ai.i.on of lac); of ful.l disc.lo�urc on my ��art . <br /> C�weET.;i2�7ivr�P"i:. � a_a�:�Pc.� i <br /> Pr.oponent : ��..__ �j,�_�_��11/ U- �.L � <br /> TV. D]:C7:,T;1:Te'PION Oi� RESPO;QS,II3T,L UI'FICIAL: �W � <br /> The aLove descr5}�ed pr.aject i.s a ciajor aci:i.on wi.i:h � <br /> (signifi.cnni:, insignifi.cant) impact and (wi11, �vi.11 not) r.eciuire an <br /> I:n��Sronmcni�nl lmpac-�: Stni:ci��ciiC . <br /> I:es��oiis.il�.te Off.i.ci.�il. <br /> I,_ 1 <br />