Cultural Resources Endangered Species - Wetlands Review Report
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1
2ILLINOIS
E.A.S. - CERP FORM
DEPARTMENT OF NATURAL RESOURCES
CERP #:
Due Date:
CULTURAL RESOURCES, ENDANGERED SPECIES & WETLANDS REVIEW REPORT
Project Sponsor:
Indicate Grant Program Type
_______ Line Item
Project Title/Site Name:
_______ OLT
_______ OSLAD/LWCF
Contact Person:
_______ Bike
Address:
_______ Boat Access
_______ Snowmobile
Phone:
_______ OHV/RTP
Date:
Check appropriate response:
[ ]
New Project Application
(not previously reviewed / considered by IDNR)
[ ]
Application Resubmittal *
* If resubmittal, indicate the year(s) previously submitted:
Has project proposal changed in scope or design layout from previous submittal(s)? [ ] Yes [ ] No
If this is a development project was the property acquired with DNR funds? [ ] Yes [ ] No
Project Location:
County:
USGS Numeric Location Designation: Township:
Range:
Section:
Please attach:
1) project site development plan
2) photocopy of a topographical map showing project area.
(Note: photocopy ONLY that portion of map where project site is located. Copies should be no larger that 11" x 17".)
(Clearly delineate and identify the “project site/park boundary” on the map with a dashed black line)
Maps may be purchased from:
Illinois State Geological Survey
Size of Project Site:
acres
Champaign, IL 60115
(allow 2 - 4 weeks for receipt of maps)
tele: 217/244-2414
(Topographical maps may also be available from local and/or regional planning commissions.)
Concise Project Description: (Also, attach 2 sets of color photos of any existing buildings/structures on project site)
DEPARTMENT USE ONLY
Approved
Approved w/ Restrictions *
Comments*
Grant Adm.___
Cultural Resources
___________
________________________ __________________________
T&E Species/ NP/Natural Area/LWR
___________
________________________ __________________________
Wetlands (Sec 404, see reverse side)
___________
________________________ __________________________
* see attached letter/comment
_________________________________ _________
Signature indicates IDNR CERP sign-off for ONLY the project information
included in this submittal. Any changes must be resubmitted for review.
OREP/RR&C/CERP Coordinator
Date
3 COPIES OF THIS FORM AND THE SPECIFIED ATTACHMENTS MUST BE SUBMITTED WITH APPLICATION EAS
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