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-' l <br />� <br />Yce Haybe No <br />� <br />(]9) Recrentfon. W111 tl�e propo�al result in an impect upon [he quality ✓ <br />or qua�tity oE existing recrcational opportunitics? ' _ _ <br />' Explonntion: ' � <br />(20) Archeologlcal/Ilis[orical. Will [he proposal resul[ in an al[eratlon <br />of a slgnificant archeologieal or his[orical site, s[ructure, object / <br />or buildinel — � <br />Explanation <br />JI. SICNATURF. <br />I, the undcrsignrd, state that [o [he best of�my knovledge Che above inConnntlon is ' <br />rue and comple[e. It is ur.derstood [hat the lcad �gency m�y withdraw any declaration oE non- <br />:ip,nfficanee [ha[ it mJFlit issue in reliance upon ttiis checklis[ should tliere be any misrepresen-i <br />ation or lack oE tull disclosurc on my part. . <br />, Prbponen[:�irl CNi�PR� f� <br />1V. llECLA1tATI0N OF RESFONSIISLE OFFICIAL: �J�� ��'c'"` <br />Ttie above describeJ projec[ is n major nction ai[h (siFnifican[; insignificant) <br />mpact and (uill, Will not) require an F.nvironmental Impac[ Statr.r.:ent. <br />RCS�OfI.^.iblc Official <br />