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From:City of South Bend <br />To:82359578 10/2612011 11:51 #478 P.0031004 <br />ENVIRONMENTAL REVIEW <br />CHECKLIST JUL 13 2011 <br />SUBGRANTEE COMPLETES: <br />,� -n J0 <br />1. Project Name: s2 Olt - <br />2. Project Description: <br />3. Address:__ � /Z&/ <br />4. Is project located near obvious source of noise, i.e.., railroa <br />industry, main arterial, or state highway? Yes_ No_!::�_ <br />(Circle the one(s)-which apply?) <br />5. Does the project involve AM of the following: <br />(a) Increase in dwelling units? Yes_ K0_2�� <br />(from units to _ units) <br />(b) Changes in zoning? Yes_ Nq_X_f <br />(c) Rehab costs will be over 75% of estimated <br />replacement value alter rehabilitation? Yes_No <br />' <br />completed by: Date: - <br />C U <br />HISTORIC PRESERVATION COMPLETES! <br />1. The property is listed on or eligible to be listed on the National <br />Register of Historic Place;: Yes No ✓ <br />2. The property is a contributing structure in an historic district: <br />Yes v, No <br />3. Comments:� /d'9y •tltl.urtr�c. �ffDL' A <br />Completed by: Date: <br />ECONOMIC DEVELOPMENT COMPLETE: <br />1. Environmental Determination: (Jw-[� A, Q, <br />2. Is project in HUD identified floodplain: Yes_ No—& Panel#AS1!AAC1* <br />D TIN <br />3. Comments: <br />Completed by: Date :2 <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 />