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Completed by: Date: HISTORIC PRESERVATION COMPLETES: 1. The property is listed on or eligible to be listed on'the National Register of Historic Places: Yes No 2. The property is a contributing structure in an historic district: Yes No 3. Comments • Completed by: Date: ECONOMIC DEVELOPMENT COMPLETE: 1. Environmental Determination: .2. Is project in HUD identified floodplain: Yes No Panel#� 3. Comments Completed by: Date: If YES is checked for any of the above, appropriate measures will be taken to insure project is in compliance with federal requirements. Copies: White to Sub Yellow to H.P. Pink to E.D. ENVIRONMENTAL REVIEW CHECKLIST SUBGRANTEE COMPLETES: 1. Project Name: 2. Project Description: �4 c n-�.�•�. �S �^� 3. Address: �/b U LO . S •x-..,.,., SZc -%�"` 4. Is.project located near obvious source of noise, i.e., railroad, industry, main arterial, or state highway? Yes No (Circle the ones) -which apply?) 5. Does the project involve pnv of the.following: (a) Increase in dwelling units? Yes No (from units to units) (b) Changes in zoning? Yes No (c) Rehab costs will be over 75% of estimated replacement value after rehabilitation? Yes No Completed by: Date: HISTORIC PRESERVATION COMPLETES: 1. The property is listed on or eligible to be listed on'the National Register of Historic Places: Yes No 2. The property is a contributing structure in an historic district: Yes No 3. Comments • Completed by: Date: ECONOMIC DEVELOPMENT COMPLETE: 1. Environmental Determination: .2. Is project in HUD identified floodplain: Yes No Panel#� 3. Comments Completed by: Date: If YES is checked for any of the above, appropriate measures will be taken to insure project is in compliance with federal requirements. Copies: White to Sub Yellow to H.P. Pink to E.D.