AGRICULTURAL IMPACT NOTICEWisconsin Department of Transportation
DT1999 2003 (Replaces ED872)
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Proposing AgencyProject ID / Highway / County
Project Title / Project Length
Type and Status of Environmental Document
Proposing Agency Wants to Review Pre-Publication Draft of AIS?
Yes No / AIS Needed by What Date?
1.Project Description
a. Describe existing facility - Include existing right of way width.
b. Describe proposed action - Include anticipated right of way width and any easements.
2.Alternatives considered - Identify the preferred alternative if any, and if other alternatives are no longer under consideration include the reasons why they are not proposed for adoption.
3.Maps and Exhibits
a. Include a project location map showing the project’s limits.
b. Include an exhibit illustrating property lines, parcel numbers, and any roadway to be obliterated. The exhibit (township plat map, aerial photograph, layout sketch, contour map, etc.) should clearly present the pertinent information and be commensurate with the scope of the project and its apparent impact on farm operations.
Farm Operation Interests of 5 Acres or Less but more than 1 Acre
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Project ID / Project TitleAcres
Parcel No. / Owner(s)
(Include operator if diff. from owner) / Acquired / Fee S. / Ease. / Existing Farm Operation / Present Use/Remarks
There are acquisitions, each one an acre or less, that are categorically non-significant totaling
Acres
Farm Operation Interest Over 5 Acres
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Parcel Number / Project IDOwner / Operator (If different from owner)
Type of Land / Acres
Before / Acquired / Remaining
Fee Simple / Easement
Cropland and pasture
Woodland
Land of undetermined or other use
Total Acres of Farm Operation
Description of farm operation and nature of acquisition - Discuss as appropriate any resulting severances, changes in access, expected changes in land use, effect on farm structures, effect on cattle or livestock passes or crossings, roadway obliteration (if any) etc.
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Mailing List - Needed when an AIS is likely to be published. Use additional sheets as necessary.
a.List the names and addresses of all affected farmland owners, and operators if different from owners. If names and addresses have not been verified indicate the date and source of information.
b.List the names and addresses of any other individual, group, club, or committee which has demonstrated an interest in and requested receipt of the AIS.