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<br /> DEPARTMENT OF TRANSPORTATION. FEDERAL AVIATION ADMINISTRATION <br /> OMB NO. 80-"01:< <br /> PART II <br /> PROJECT APPROVAL INFORMATION <br /> SECTION A <br /> Item 1. <br /> Does this assistance request require State, local, Name of Governing Body <br /> regional, or other priority rating? Priority Rating <br /> Yes X No <br /> <br /> Item 2. <br /> Does this ossistance requ~st ,require State, or local Nome of Agency or <br /> advisory, educational or health clearances? Board <br /> Yes X No (Attach Documentation) <br /> <br /> Item 3. <br /> Does this assistance request require clearinghouse review (Attach Comments) <br /> in accordance with OMB Circular A-95? <br /> Yes X 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 /> hem 5. <br /> I s the proposed pro ject covered by an approved Check one: State ~ <br /> comprehensive plan? Local <br /> Regional ~n <br /> '- . <br /> Yes X No Location of plari <br /> <br /> Item 6. <br /> 'ViII the assistance requested serve a Federal Name of Federal Installation <br /> nstallation? Yes X No Federal Population benefiting from Project <br /> <br /> Item 7. <br /> Will 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 assistance requested cause the displacement of Individual s <br /> individuals families, businesses, or farms? Families <br /> Businesses <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 /> project previous, pending, or anticipated? provided. <br /> Yes X No <br /> <br /> FAA Form 5100.100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7 Poge2 <br />