01156Yes Maybe Nu_
1 (17) Human Ilea liWill the proposal
'2 res-- uTt--tii CFI 'creation of any `
3 health hazard.ur potential health
4 hazard (excluding mental health)? P:
51 ti
i 6 Explanation; t
t 7 k.
i g (18) Aesthetics: Will the proposal
10 result n the obstruction of any
11 scenic vista or view open to the
` 12 public, or will the proposal rc-
13
sult in the creation of an
14
aesthetically offensive site open
15
to public view?
,
16:
17
Explanation:
19
t'
20
(19) Recreation, Will Lhe proposal
,
21
result in an impact upon the
22
quality or quantity of existing
23
recreational opportunities?
.:
24
rr
'
�.
25
Explanation:
26
27
S
i
28
'(20) Arch�olo ic.�l./1listorical. Will the
29
proposes result in an aTteration of
f,.
30
a significant archeological or his-
31
32
torical site, structure, object
or building?
1
33
34
Explanation:
35
-37
III. SIGNATURE
38
39
I, the undersigned, state that to the best of my knowledge
40
Ahe above; information is true and complete. It is understood
41
`that the lead agency may withdraw any declaration of non-signi=
42
ficanee that it might issue in reliance upon this checklist
j
43
`should there be any misrepresentation or lack of full disclosure
j
44
on my part.
45
46
Proponent:.
47
4
t
48
WAC 197-10-370 WITHDRAWAL OF AFFIM,1A'1' NE TIIRES11OLD
4.9
DET'UOTIfiA'TMN. if at any time after the entry of a declara-
r.
50
tion of significance, the proponent modifies the proposal
{ i
51
so that, in the judgment of the lead agency, all significant
52
adverse environmental impacts resulting; therefrom are elimin-
53
ated. the declaration of significance fliall be withdrawn
f
54
and a declaration of non -significance entered instead. The
55'
lead agency shall also revise the registo s at its SEPA•
j
56
public information center accordingly, if the pro-
57
' -poni-nt of a proposal is a private applicant, the proposal
'
1.
58
shall not be considered modified until all license applica-
59
tions for the proposal are revised to reflect the modification.
-37-
1 .I