Res 1995-160 - Laserfiche WebLink

Home Browse Search

!oqp YES NO 3. PROGRAM AMENDMENT (Change in scope or type of activities) M [] If YES, the following documentation must be submitted. In addition, please answer the questions listed below: Documentation required for a PROGRAM AMENDMENT: 1. Revised Performance Statement that indicates all physical changes in the project including, but not limited to, changes in the project location(s), number of linear feet, number of sub-activities (Le., fire hydrants, manholes, etc.), changes in system capacity, etc. 2. Project Map showing (a) location of original project activities and proposed activities; (b) original and amended target areas; and (c) geographical area covered in the original environmental assessment. 3. Local Resolution of support for the proposed PROGRAM AMENDMENT. Questions concerning the proposed Program Amendment: YES NO A. Changes in ScopelType of Activity l><J [] 1. Increase in Scope [] Þ<J 2. Decrease in Scope P<J [] 3. Change/addition of type of activity . [] Þ<J 4. Design modification/Change in location [] fX1 B. Status of Low and Moderate Income Beneficiaries YES NO 1. Is there a change in the number and/or percentage of [] P<\1 low and moderate income beneficiaries? If YES, include survey forms of the additional and/or removed beneficiaries, and document the amended low and moderate income beneficiaries (lMIB) in the spaces provided below: Number of lMIB = % lMIB I = % Total Beneficiaries C. Re-evaluation of the Environmental Clearance YES NO 1. Does the original environmental clearance include the ~ [] geographical area in the proposed amendment? Please indicate this geographical area on the project map. 2. Are all types of activities (e.g., water, sewer, streets) Þ<J [] in the proposed amendment addressed in the original environmental assessment? If a response is NO to either question, please re-evaluate the original environmental assessment and submit with this amendment request. 4-8