Wisconsin

Federal Highway Administration

Finding of De Minimis Impact on Parks, Recreation Areas and Wildlife and Waterfowl Refuges

WISDOT ID:

Route:

Termini:

City/County:

Name of 4(f) Resource: [Park, recreation area, or wildlife and waterfowl refuge]

Project description: [Brief project description and specific 4(f) impact; indicate any measures that were taken to minimize harm to the protected property,including any measures to avoid, minimize, mitigate, or enhance the property and committed to in the environmental documentation. State project name and if the project is an Enhancement Project. Include total cost, length in miles, class of NEPA action, and acres of de minimis use.]

The attached documentation shows the following:

  1. A. What the activities, features, and attributes are that qualify [name of the resource] for protection under Section 4(f).

B. What the transportation use of the Section 4(f) resource is.

C. How this use does not adversely affect the activities, features, and attributes listed in 1.A., above. In making this determination, consideration may be given to any impact avoidance, minimization, and mitigation or enhancement measures incorporated into the project; and

  1. [Name of the official(s) with jurisdiction over the property] has/have been informed that FHWA may make a de minimis finding under 4(f) and may use the [Name of official(s)]’s written concurrence that the project does not adversely affect the activities, features, and attributes listed in 1.A., above that qualify the property for protection under Section 4(f) in making that finding[attach a copy of the official(s) letter(s)]; and
  2. The public has been afforded an opportunity to review and comment on the effects of the project on the protected activities, features, and attributes of the Section 4(f) resource. [Provide appropriate documentation]
  3. There are no federal encumbrances [such as 6(f)] on [name of Park, Recreation Area or Wildlife or WaterfowlRefuge] OR [A federal encumbrance—such as 6(f)]was identified on [name of Park, Recreation Area or Wildlife or WaterfowlRefuge]and all requirements relating to [that regulation]will be satisfied independent of this 4(f) determination.

This de minimis documentation was prepared by

______[signature]______

Date[name & title--consultant or Region]

This de minimis documentation was reviewed and approved by

______[signature]______

Date[Name], (Regional Environmental Coordinator or

Region Local Program Manager)

______[signature]______

Date [Name], ESS (Liaison or Section Manager)

______[signature]______

Date[Name],Federal Highway Administration

Cc: WISDOT Bureau of TechnicalServices/ Environmental Services Section

WISDOT Region

07-26-10