Wisc. Dept of Transportation - BUREAU OF AERONAUTICS

CULTURAL RESOURCES

Streamlined Section 106

Section I. Project Information / WHS #
FOS/DOT Project ID / AIP # / County
Town(s) / Township/Range / Section(s)
Airport Name / Project Name
Project Engineer/Project Manager / (Area Code) Telephone Number
Section II. Project Description
Highest Level of Participation
Federal (including project management)
State (this form not applicable) / Type of Project
New Construction
Reconstruction / Land Acquisition
Other: ______
Amount to be disturbed in acres (must be under ½ acre) / Land to be acquired in acres
Brief Project Description (Include Location)
Attachments / Maps / Aerials / Project Plans / Photos
Aeronautics Project Manager (signature) Date
FOR CULTURAL RESOURCE REVIEWER ONLY
Section III. Wisconsin Historic Preservation Review
Sources Researched / WHPD – ASI / WHPD – AHI
Archaeological Resources:
No identified archaeological sites in the project area / Comments attached
Archaeological sites identified in the project area / Additional research is recommended
47_____-______Description______/ 47_____-______Description______
47_____-______Description______/ 47_____-______Description______
Burial Sites: (C=Catalogued)
No known historic or prehistoric cemeteries or burial grounds in or adjacent to project area
Historic or prehistoric cemeteries or burial grounds identified in or adjacent to project area
B_____-______Description______C / B_____-______Description______C
B_____-______Description______C / B_____-______Description______C
Reviewed By (signature) Date / Archaeology continued on back
Architecture/History Resources:
No historic building/structures identified in the project area / Comments attached
Historic building/structures identified in or adjacent to the project area.
AHI#______Previously evaluated as______/ AHI#______Previously evaluated as______
AHI#______Previously evaluated as______/ AHI#______Previously evaluated as______
Reviewed By (signature) Date / History continued on back

Section IV. WisDOT Cultural Resource Comments/decision

No historic properties (historical or archaeological) affected
Commitments required - See attached
Historic properties affected (Coordination/negotiations with WHS required. Begin complete Section 106 process)
WisDOT Cultural Resources (signature) Date / State Historic Preservation Office (signature) Date
Archaeology continued
History continued

401adev.docx Rev. Date: 3/4/2015 Page 1 of 2