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<br />DEPARTMENT OF TRANSPORTATION. FEDERAL AVIATION ADMINISTRATION <br />PART II OMl1 NO. 80-RO 186 <br /> <br />PROJECT APPROVAL INFORMATION <br /> <br /> <br /> <br />C'CS .h,s assistance request require State, local, Nome of Governing Body <br />",'J J"ol, or other priority rating? Priority Rating <br />Yes X No <br /> <br /> <br />',,~ ? <br /> <br />" "5 'h:~ assistance request require State, or local Nome of Agency or <br /><;('r; educational or health clearances? Boord <br /> <br />'Yes X No (Attach Documentation) <br /> <br />: "0 J. <br />C ,'his assistance request require clearinghouse (Attach Comments) <br />lev'ew in accordance with OMB Circular A.95? <br /> <br />X Yes No <br /> <br />[rem 4, <br />Does this assistance request require State, local, Nome of Approving Agency <br />rc9'cnal or other planning approval? Dote <br />Yes X No <br /> <br />!, (:'1 5, <br />'he proposed project covered by on approved compre. Check one: Stote I, <br />r'.""'-I'plan? Locol [',I <br />7 Regional [1 <br />- X Yes No Location of Plan <br /> <br />I fen', Ó, <br />~e assistance requested serve a Federal Name af Federal Installation <br />,,; 'J'ron? Yes Y No Federal Population benefiting from Project <br /> <br />--, -, -,'- <br /> <br /> <br />, e é;ssistance requested be on Federal land or Nome of Federal Installation <br />- 'J:,')n? Location of Federal Land <br />Yes X No Percent of Project ---, <br /> <br />" c, <br />", : the ass; stance requested have an impact or effect See instructions for additional information ta be <br />aI' :he environment? provided. <br />Yes X No <br /> <br />'!em'!, Number of: <br />',1,',[' !he assistance requested couse the displacement Individuals <br />C' "d,v,duals, families, businesses, or farms? Families <br />Businesses <br />Yes X No Farms <br /> <br /> <br />11(::'1 10. <br />¡;-ther; other related assistance on this project previous, See instructions for additional information to be <br /> <br />,',:ncing, or anticipated? provided. <br />Yes X No <br /> <br />FAA Form 5100.101 16.73) SUPERSEDES FAA FORM S9IO-1 AND 5920-1 Page 2 <br />