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<br /> O!:PARTMENT OF TR-'NSPORTATIOH. FEDERAL AVIATION ADMINISTRATION <br /> PART" OMU NO. 80oRO '86 <br /> PROJECT APPROVAL INFORMATION <br /> Item 1. <br /> Does this assistance request require State, local, Nome of Governing Body <br /> reg'lonol, or other priority rating? Priority Rating <br /> Yes X No <br /> .---, <br /> : rem 2. <br /> Does this assistance request require State, or local Nome of Agency or <br /> :-d-,-,-, serv, educational or health clearances? Board <br /> -Yes X No (Attach Documentation) <br /> -, <br /> ¡I t'lr. 3. <br /> Docs th, sassi stance request require clearinghouse (Attach Comments") <br /> reView in accordance with OMB Circular A.95? <br /> X Yes No <br /> <br /> Item 4. <br /> Docs this assistance request require State, local, Nome of Approving Agency <br /> regional or other planning approval? Dote <br /> Yes X No <br /> ---,,-'. <br /> Item 5. <br /> \ 5 the proposed project covered by an approved compre- Check one: State Î, i <br /> henslve plan? Local I-: i <br /> Regional [J <br /> X Yes No Location of Plan <br /> ---- <br /> Item 6. <br /> \'Iil\ the assistance requested serve a Federal Nome of Federal Installation <br /> 'n5101Iallon? Yes X No Federal Population benefiting from Project <br /> --,-",-- <br /> I Lc:.::'. <br /> ,i1e assistance requested be on Federal land or Nome of Federal Installation <br /> 'Jllation? Location of Federal Land <br /> Yes X No Percent of Project <br /> <br /> --, <br /> 11 e:1; 8. <br /> "',;1 the ossistance requested have an impact or effect See instructions for additional information to be <br /> 011 Ihe environment? provided. <br /> Yes X No <br /> <br /> Item 9. Number of: <br /> Will the assistance requested cause the displacement Individual s <br /> of individuals, families, businesses, or forms? Families <br /> Businesses <br /> Yes X No Farms <br /> <br /> Item 10. <br /> --- See instructions for additional information to be <br /> \s there other related assistance on this project previous, <br /> p'::nding, or anticipated? pro vi ded. <br /> Yes X No <br /> <br /> FAA Form 5100.101 16-73) SUPERSEDES FAA FORM s~\o.\ AND 5920.\ Page 2 <br />