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<br /> DEPARTMENT OF TRANSPORTATION. FEDERAL AVIA nOH ADMIHISTRA T IOH <br /> ;:Vb"~ so."o.,. <br /> PART II <br /> PROJECT APPROVAL INFORMATION <br /> SECTION A <br /> Item 1. <br /> Does this assistance request require Stote, local, Name of Governing Body <br /> regional, or other priority rating? Priority Rating <br /> Yes X No <br /> <br /> Item 2. <br /> ~- :s this assistance request require State, or local Name of Agency or <br /> 'isory, educational or health clearances? Board <br /> <br /> Yes X No (Attach Documentation) <br /> <br /> Item 3. <br /> Does this assistance request require clearinghouse review (Attach Comments) <br /> in accordonce with OMB Circular A-9S? <br /> X Yes No <br /> <br /> Item 4. <br /> Does this assistance request require State, local, Name of Approving Agency <br /> regional or other planning approval? Date <br /> Yes X No <br /> <br /> Item 5. <br /> Is the proposed project covered by an approved Check one: State -- . <br /> comprehensive plan? local -. <br /> X Regional <br /> Yes No location of pIon <br /> <br /> Item 6. <br /> Will the assistance requested serve a Federal Name of Federal Installation <br /> installation? Yes X No Federal Population benefiting from Project <br /> <br /> em 7. <br /> ill the assistance requested be on Federal land Name of Federal Installation <br /> or installation? location of Federal land <br /> Yes X No Percent of Project <br /> <br /> Item 8. <br /> Will the assistance requested have an impact or effect See instruction for additional information to be <br /> on the environment? provided. <br /> Yes X No <br /> <br /> Item 9. Number of: <br /> Will the assistonce requested cause the displacement of Individual s <br /> individuol s families, businesses, or farms? Families <br /> Bus ines ses <br /> Yes 'X' No Farms <br /> <br /> Item 10. <br /> Is there other related Federal assistance on this See instructions for additional information to be <br /> proiect previous, pending, or anticipated? provided. <br /> Yes X No <br /> <br /> FAA Form 5100-100 (6-13) SUPERSEDES FAA FOR'" S100-10 PAGES 1 THRU 1 Page 2 <br />