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<br />STATEWIDE TRANSPORTATION ENHANCEMENT PROGRAM <br />PaCle 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 checklist of environmental factors. For each of the listed factors, answer the question of whether your <br />proposed project would have been 8 Beneficial 18l effect, 8 Neutral (NJ effect, or an Adverse tA) effect. 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 enhancement projects will have minor. if any, impacts on these listed factors. However, it is <br />important that Bach factor is considered and your response is indicated in the appropriate box. <br /> <br />Note: Check only one box for each line. Do not skip any lines. <br /> <br />:: Key to /mp.ct$: B""beMlfici.l; N "" Neutr./; A ""Mdverse; n/.-=not .pplic.ble. <br /> <br />FACTORS Type of Impact B N A nla <br />Socio-Economic Factors Land-use Change/Consistency with local Plans 0 0 0 0 <br /> Economic Impacts 0 0 0 0 <br /> Impacts on Neighborhoods/Community Cohesion 0 0 0 0 <br /> Relocation of Residences/Businesses 0 0 0 0 <br /> Impacts on Churches/Schools 0 0 0 0 <br /> Title VI Impacts ILe., impacts to ethnic, minority, elderly, 0 0 0 0 <br /> disabled, or other groups) <br /> Potential for Controversy Yes No <br />R..ouru Factor. Section4(f) Properties (publicly-owned parks, recreation areas, <br /> wildlife and waterfowl refuges, and aU historical sites (in public <br /> or private ownership) included on or eligible for the National 0 0 0 0 <br /> Register of Historic Placesl <br /> Historic Sites and Districts 0 0 0 0 <br /> Archaeological Resources 0 0 0 0 <br /> Recreation Areas 0 0 0 0 <br /> Wetlands 0 0 0 0 <br /> Aquatic Preserves (wildlife and waterfowl refuges) 0 0 0 0 <br /> Stream Modification 0 0 0 0 <br /> {Continued on next p.gei <br />