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1029-00'9 <br /> U.S. DEPARTMENT OF THE INTERI(_ <br /> Mae of Surface Mining <br /> PROJECT APPROVAL INFORMATION <br /> SECTION A <br /> Item 1. <br /> Does this assistance request require State,local, NanisofGoverning Boot Mined Land Recl amatl on Board <br /> regional.or other priority rating? Priority Elating <br /> Yes No <br /> Item Z. <br /> Does this assistance request require State.or local Name of Agency or <br /> advisory,educational or health clearances? Board <br /> Yes y_ No (Attach Documentation) <br /> Item 3. <br /> Does ants assistance request require clearinghouse (Attach Comments) <br /> review in accordance with OX �6 a Circular A ? See public participation in ADDendi x <br /> Yea NO <br /> Item 4. <br /> Does this assistance request require State, local. Name Of Approving Agency <br /> regional or other planning approval? Date <br /> Yes No <br /> Item S. <br /> is the proposed project covered by an approved Chacx one: State 3 _ <br /> comprehensive plan? Local -� <br /> Regional <br /> X Yes No Locatlonof Plan Mined I And 20I.1 arr"J nr ri vision <br /> Item 6. <br /> will the assistance requested serve a Federal Name of Federal Installation %/A <br /> installation? Federal Population oenstiting from Project <br /> Yes NO <br /> Item 7. <br /> Will the assistance requested be on Federal land Name of Federal Installation <br /> or installation? Location of Feoerai Land <br /> Yes No Percent of Protect <br /> Item& <br /> will the assistance requested nave an impact or See instructions for additional information to oe <br /> ettect on the environment? provided. <br /> X Yes NO See tnvi ronm?nial A$SeSStn?n-. <br /> lit. 'n 2. Number at. <br /> Will the assistance requested cause the displacement Inotvicuats <br /> of individual&families,businesses,or tarms? Families <br /> Businesses <br /> Yes Y No Farms <br /> Item III <br /> is triers,other related assistance on this project See instructions for additional information to oe <br /> prewoasi pending, or anticipated? provided. <br /> Yes v No <br /> Item 11. <br /> r Is the project in a designated flood nazare area? See instructions for additional information to oe <br /> provided. <br /> Yes X No <br /> OSM-50A (6/80) <br /> X-3 <br />