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<br />STATEWIDE TRANSPORTATION ENHANCEMENT PROGRAM. <br />Paae 7 <br /> <br />Nomination <br />Form <br /> <br />D. POSSIBLE PROJECT IMPACTS. Indicate possible impacts <br />enhancement project on the resource categories listed below. <br /> <br />of the proposed <br /> <br />GENERAL <br /> <br />Following is 8 ChBCklist of environmental fBctors. For eBch of thB/istBd factors, answer the question of whether your <br />proposed project would have been 8 Beneficial (8) effect, 8 Neutral (N) effect. or an Adverse fAlstfect. For example, <br />would your project create any significant Lend-Use Change. or is it Consistent with Local Plans? Would it have any <br />beneficial or adverse Economic Impacts? <br /> <br />Many transportation fmhancement projects will have minor, if any, impacts on these listed factors. However, it is <br />important that each factor is considered and your response is indicated in the appropriate box. <br /> <br />Note: Ch8Ck only one box for each line. Do not skip any lines. <br /> <br />:: Key to Imp.ct6: B=b.".fici.l; N = N.utr.l; A =.dv"r6"; n/. =not .pplic.bl". <br /> <br />FACTORS Type of Impact B N A nla <br />Socio-Economic Factors Land-use Change/Consistency with Local Plans 0 0 D D <br /> Economic Impacts 0 D D D <br /> Impacts on Neighborhoods/Community Cohesion D D D D <br /> Relocation of Residences/Businesses D D D D <br /> Impacts on Churches/Schools 0 0 D D <br /> Title VI Impacts (i.e., impacts to ethnic, minority, elderly, D D D D <br /> disabled, or other groups) <br /> Potential for Controversy Yes No <br /> <br />"our~ Factor. Section 4(f) Properties (publicly-owned parks, recreation areas, <br /> wildlife and weterfowl refuges, and all historical sites (in public <br /> or private ownership) included on or eligible for the National D 0 D D <br /> Register of Historic Pieces) <br /> Historic Sites and Districts 0 0 D D <br /> Archaeological Resources 0 0 D 0 <br /> Recreation Areas 0 0 D 0 <br /> Wetlands D 0 0 0 <br /> Aquatic Preserves (wildlife and waterfowl refuges) 0 0 0 0 <br /> Stream Modification 0 0 D 0 <br /> {Continued on next p.ge] <br />