Worksheet for Preparing 24 CFR §58.5 Statutory Checklist [Attach to Statutory Checklist] 1. [36 CFR 800] YES NO IF YES, IF NO, “A” RE (SHPO) (PA) IF PA. IF NO, C. 45 (APE)? YES NO A SHPO “A” SHPO YES, IF SHPO SHPO IF YES, IF “A” SHPO RE IF YES, include mitigation requirements and/or conditions from the SHPO in the mitigation section of the Statutory Checklist. Mark box on the Statutory Checklist for this authority. “B” NO, i. Does the project include the types of activities such as those listed below that have the potential to affect historic properties of religious and cultural significance to tribes? Ground disturbance (digging); New construction in undeveloped natural areas; Incongruent visual changes impairment of the or viewshed from an observation point in – the natural landscape; Incongruent audible changes increase in noise levels above an acceptable standard in areas – known for their quiet, contemplative experience;
Worksheet for Preparing 24 CFR §58.5 Statutory Checklist [Attach to Statutory Checklist] 1. [36 CFR 800] YES NO IF YES, “A” RE (SHPO) (PA) PA. 45 (APE)? IF YES IF NO A SHPO “A” SHPO IF YES, IF NO, SHPO SHPO IF YES, IF NO, “A” SHPO RE IF YES, include mitigation requirements and/or conditions from the SHPO in the mitigation section of the Statutory Checklist. Mark box “B” on the Statutory Checklist for this authority. i. Does the project include the types of activities such as those listed below that have the potential to affect historic properties of religious and cultural significance to tribes? Ground disturbance (digging); New construction in undeveloped natural areas; Incongruent visual changes – impairment of the or viewshed from an observation point in the natural landscape; Incongruent audible changes – increase in noise levels above an acceptable standard in areas known for their quiet, contemplative experience; NO, C.
mfa_environmental_checklist_58.5_statutory_checklist.docx