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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 B checklist of environmental fBctors. Fo, each of the/isted factors, answer the question of whether your <br />proposed project would have been B Beneficial fB) effect, 8 Neutral (N) effect, or an Adverse fA) effect. Fo, example, <br />would your project create any significant Land-Use Change, or is it Consisttmt 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 each factor is considered and your response is indicated in the appropriate box. <br /> <br />Note: Check only one box for Bach line. Do not skip any lines. <br /> <br />:: Key to Imp.ct6: B=benefici.J; N = Neutr.J; A =.dver6e; n/.=not .pplic.b1e. <br /> <br />FACTORS Type of Impact B N A nla <br />Socio.Economic Facton Land-use Change/Consistency with Local Plans D D D D <br /> Economic Impacts D 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 D D D D <br /> Title VI Impacts (Le., impacts to ethnic, minority, elderly, D D D D <br /> disabled, or other groups) <br /> Potential for Controversy Yes No <br /> <br />R..ourc. F.ctor. Section 4(f) Properties (publicly.owned parks, recreation areas, <br /> wildlife and waterfowl refuges, and all historical sites (in public <br /> or private ownership) included on or eligible for the National D D D D <br /> Register of Historic Places) <br /> Historic Sites and Districts D D D D <br /> Archaeological Resources D D D D <br /> Recreation Areas D D D D <br /> Wetlands D D D D <br /> Aquatic Preserves (wildlife and waterfowl refuges) D D D D <br /> Stream Modification D D D D <br /> {Continued on next p.ge] <br />