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<br />I <br /> <br />U.S. Department of Agriculture <br /> <br />I <br /> <br />FARMLAND CONVERSION IMPACT RATING <br /> <br />PART I (To be completed by Federal Agency) <br />I Nome Of p, <br /> <br /> <br />f,.f) 'u..l- <br /> <br /> <br />~ at <br /> <br />t <br />if"''' e C;,. <br />Proposed Land Use <br />Fl <br />I PART II (To e completed by SCS) Date ReqU~ t Received ~B'r' SCS <br /> <br />Does the site contai~ prime, unique, statewide or tocal important farmland? Ve} No Acres Irrigated <br />(II no, the FPPA does not apply - do not complete additional parts 01 this form). 0 0 LL <br /> <br />I <br /> <br />I <br /> <br /> , <br />Major Crop(sJ Farmable Land In Govt. JurisdictIOn I Amount Of Farmland As -Defined in FPPA <br />(f>ftl 5IJaa.L1~~.l;b_.-,1lfalf;l Acres: q:SQ..J,.qQQ % M.:" Acres: 19.(J. ~a:! % Ido.:; <br />Name Of Land E luation System Used Name Of Local Site Assessment System Date Land Evaluatlon Returned BV SCS <br /> I ~f,t:I. - il...-v:\ .:0 1m <br />PART III (To be completed by Federal Agency) Alternati e SltP Rating <br /> Site A $Ite 6 I $Ite C Site 0 <br />A. Total Acres To Be Converted Directly ~.3 CZ8) ~~ (Z8)..: <br />B. Total Acres To Be Converted Indirectly I 0 0 I <br />C. Total Acres In Site , '15 "" <br />PART IV (To be completed bySCS) Land Evaluation Information <br />A. Total Acres Prime And Unique Farmland I"> _"l l"o.=> <br />B. Total Acres Statewide. And local Important Farmland I ,~ I" <br />C. Percentage Of Farmland In County Or local Govt: Unit To Be Converted ,""" .~I <br />D. Percentage Of Farmland In Govt. Jurisdiction With Same Or Higher Relative Value ,?'..-<: ,... <" <br />PART V (To be completed by SCSI land Evaluation Criterion Po;:) A.. '1 <br /> Relative Value Of Farmland To Be Converted (Scale 010 to 100 Points) <br />PART VI (To be completed by Federal Agency) Maximum I I <br />Site Assessment Criteria (These criteria are explained in 7 CF R 658.5(b) Points I I <br /> I <br />1. Area In Nonurban Use 150 t /II I~ I <br />2. Perimeter In Nonurban Use 10 /0 I I" I <br />3. Percent Of Site Being Farmed :10 ,,, I I" : <br />4. Protection Provided By State And Local Government "" I 0 I 'D <br />5. Distance From Urban Builtup Area ~ /I I t? <br />6. Distance To Urban Support Services I ,., I 0 n <br />7. Size Of Present Farm Unit Compared To Average ! .n ! 10 If) <br />B. Creation Of Nonfarmable Farmland ~ , () 0 <br />9. Availebility Of Farm Sunport Services ~ I 5 I 5 <br />10. On-Farm Investments I/() I NJ 10 <br /> I <br />11. Effects Of Conversion On Farm Support Services ~'" , 0 0 I <br /> I I <br />12. Compatibility With Existing Anricultural Use .0 , 2. Z. <br />TOTAL SITE ASSESSMENT POINTS 160 I (.,~ ~7 <br />PART VII (To be completed by Federal Agency) <br />Relative Value Of Farmland (From Part V) 100 ~ 2 gz. <br />rotal Site Asserment (From Part VI above or a local 160 (pI, t>7 <br />site assessment <br />TOTAL POINTS (Total of above 2 lines) 260 If f 11/1 <br /> T Date Of Selection 5";'~/99 Was A Local Site Assessment Used? <br />Site Selected: 'tf' Ves 0 No 0 <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I <br /> <br />I Reason For;;:;'''}es Ia.Yf~$1 CVH10J- llf FiooJ profevh~ ~ <br />i~ad ~ 5;fl1;r:c.....J (b-rrv./~ r($()u.vc.t..S. <br /> <br />has <br /> <br />stili!!; <br /> <br />10 <<J"f" <br /> <br />I <br /> <br />IIZ" .. .,.. \f.... G-o"-shJ....f f\o.J4 o...e. pkMlt~ It, he. ~ ., 'Y't"fJ.,). err(W, <br />I ..jl.G."'~.. .............. <br /> <br />Form AD.tOOG (10-83) <br /> <br />(See Instruction:> on reverse side) <br />