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