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PART II <br />PROJECT APPROVAL INFORMATION <br />Item 1. <br />Does this assistance request require state, local, Nameof Governing Body <br />regional, or other priority rating? Priority Rating <br />❑ Yes ❑ No <br />Item 2. <br />Does this assistance request require state, or local Name of Agency or Board_ <br />advisory, educational, or health clearance? (Attach Documentation) <br />❑ Yes ❑ No <br />Item . <br />Does this assistance request require TRACS review? (Attach Comments) <br />❑ Yes ❑ No <br />Item 4' Name of Approving Agency <br />Does this assistance request require state, local, <br />regional, or other planning approval? Date <br />❑ Yes ❑ No <br />Item 5. State <br />Is the proposed project covered by an approved Check One: ❑ Local <br />comprehensive plan? ❑ Regional <br />El Yes El No Location of Plan <br />I m NameofFederallnstallation <br />Will the assistance requested serve a federal Federal Population Benefiting from Project <br />installation? <br />❑ Yes ❑ No — <br />Item 7. NameofFederallnstallation <br />Will the assistance required be on federal land or Location of Federal Land <br />installation? <br />❑ Yes No <br />Percent of Project <br />❑ <br />Item 8. <br />Will the assistance requested have an impact or See instructions for additional information to e <br />effect on the environment? provided. <br />❑ Yes ❑ No <br />Item 9. <br />Will the assistance requested cause the displace- <br />ment of individuals, families, businesses or farms? <br />❑ Yes ❑ No <br />Number of: Individuals <br />Families <br />Businesses <br />Farms <br />Item 10. <br />Is there other related assistance on this project See instructions for additional information to be <br />previous, pending, or anticipated? provided. <br />❑ Yes ❑ No <br />Item 11. See instructions for additional information to be <br />Is the project in a designated flood hazard area? provided. <br />❑ Yes ❑ No <br />CJD -3 <br />