WISCONSIN DIVISION FEDERAL HIGHWAY ADMINISTRATION PROGRAMMATIC SECTION 4(f) DETERMINATION AND APPROVAL UNDER THE NATIONWIDE SECTION 4(f) EVALUATION AND APPROVAL FOR FEDERALLY-AIDED HIGHWAY PROJECTS WITH MINOR INVOLVEMENTS WITH HISTORIC SITES (DECEMBER 23, 1986) Description/Location of Project: Federal Project Number: WISDOT ID: Route: Termini: County: Name of Resource: Consult the Nationwide Section 4(f) Evaluation as it relates to the following items. Complete all items. Any response in a requires additional information prior to approval. This determination will be attached to the applicable environmental document. Eligibility Criteria YES NO 1. Is the historic site adjacent to the existing highway? 2. Does the project require the removal or alteration of historic buildings, structures, or objects on the historic sites? 3. Does the project require the disturbance or removal of archeological resources which are important to preserve in place rather than to recover for archeological research based on consultation with the SHPO and if appropriate the ACHP? 4. Is the impact on the 4(f) site considered minor (i.e. no effect, no adverse effect) and the ACHP has not objected to a "no adverse effect" determination? 5. Has the SHPO agreed, in writing, with the assessment of impacts and the proposed mitigation for the historic site? 6. Does the project require the preparation of an EIS? 7. Is the project on new location? 8. The scope of the project is one of the following: (indicate one in Yes-box) a. Improved Traffic Operations b. Safety Improvements c. 4R
WISCONSIN DIVISION FEDERAL HIGHWAY ADMINISTRATION PROGRAMMATIC SECTION 4(f) DETERMINATION AND APPROVAL UNDER THE NATIONWIDE SECTION 4(f) EVALUATION AND APPROVAL FOR FEDERALLY-AIDED HIGHWAY PROJECTS WITH MINOR INVOLVEMENTS WITH HISTORIC SITES (DECEMBER 23, 1986) Description/Location of Project: Federal Project Number: WISDOT ID: Route: Termini: County: Name of Resource: Consult the Nationwide Section 4(f) Evaluation as it relates to the following items. Complete all items. Any response in a requires additional information prior to approval. This determination will be attached to the applicable environmental document. Eligibility Criteria YES NO 1. Is the historic site adjacent to the existing highway? 2. Does the project require the removal or alteration of historic buildings, structures, or objects on the historic sites? 3. Does the project require the disturbance or removal of archeological resources which are important to preserve in place rather than to recover for archeological research based on consultation with the SHPO and if appropriate the ACHP? 4. Is the impact on the 4(f) site considered minor (i.e. no effect, no adverse effect) and the ACHP has not objected to a "no adverse effect" determination? 5. Has the SHPO agreed, in writing, with the assessment of impacts and the proposed mitigation for the historic site? 6. Does the project require the preparation of an EIS? 7. Is the project on new location? 8. The scope of the project is one of the following: (indicate one in Yes-box) a. Improved Traffic Operations b. Safety Improvements c. 4R
minorinvolv4fhsite.docx