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PART II <br />PROJECT APPROVAL INFORMATION <br />Item 1. - <br />Does this assistance request require Slate, local, Nome of Goveming Body <br />regional, or other priority rating? Priority Rating <br />Yes No <br />owe No. eano tea <br />Item 2. <br />Number of: <br />Will the assistance requested cause the displacement <br />Does this assistance request require Slate, or local <br />of individuals, families, businesses, or forms? <br />Nome of Agency or <br />advisory, educational or health clearances? <br />Businesses <br />Board <br />Forms <br />Yes_ <br />No <br />(Attach Documentation) <br />Item ]. <br />pending, or anticipated? <br />provided. <br />Does this assistance request require clearinghouse <br />(Attach Comments) <br />review in occordonce with OMB Circular A•95? <br />is the project in • designated flood hazard arts? <br />Sao Instructions for additional Information to <br />Yes Na <br />be provided. <br />Item A. <br />Does this assistance request require Stoic, locol, <br />Name of Approving Agency <br />regional or other planning approval? <br />Dote <br />Yes <br />No <br />Item 5. <br />Is the proposed project covered by an approved compre- <br />Check one: Stole F' , f' <br />bentive plan? <br />Local r I <br />Regional r <br />Yes <br />No <br />Location of Plan <br />Item 6. <br />Will the assistance requested serve o Federal <br />Nome of Federal Insiollalion <br />instollotion? Yes <br />No <br />Federal Population benefiting from Project <br />Item 7. <br />Will the assistonce requested be on Federal land or <br />Nome of Federol Installation <br />in a toIlotron? <br />Localion of Federal Land <br />Yes <br />No <br />Percent of Project _ <br />Item 8. <br />Will the otsisionce requested have an impact or effect See instructions (or additional information to be <br />on the environment? provided. <br />Yes No <br />Item 9. <br />Number of: <br />Will the assistance requested cause the displacement <br />Individuals <br />of individuals, families, businesses, or forms? <br />Fomihas _ <br />Businesses <br />Yes No <br />Forms <br />Um 10 <br />Is there other reloted assistance on this project previous, <br />See instructions for additional information to be <br />pending, or anticipated? <br />provided. <br />Yes No <br />lam tl. <br />is the project in • designated flood hazard arts? <br />Sao Instructions for additional Information to <br />be provided. <br />Yea No <br />CJ D-4 Next page number is CJD -6 <br />