for NEBRASKA DED
Name of Project ______
Applicant:______Developer:______
Date of Visit:______ Visited by:______
Property Address of Site(s) proposed for the project:
______
Shape of Site Square Rectangular Other______(long narrow sites should be avoided)
Slope of Site No Slope Slight Slope Medium Slope Steep Slope
ATTACH Aerial maps of the project site and surroundings and clearly identify the site on the map.
Proposed HOME Request:______Proposed Total Project Cost:______
Description of All activities proposed for the project:
The project activities include: acquisition rehabilitation new construction demolition
road construction street changes/improvements (i.e. lights, turn lanes, etc.) Other______
Number of Units proposed ______Type of Residential Developmentsingle family multi-family
Number of buildings proposed____ townhouses (duplex, 3-plex) elderly
Sq. Footage of each bldg.______ special needs Other______
ATTACH a proposed site plan for the project.
Is the site located in a suitable neighborhood or location? (consider noise, traffic, view, air pollution, etc.) Yes No
Are there any mitigating measures needed for the project? Yes No
These measures will include:______
Does the property meet HUD Site and Neighborhood Standards? (avoid locations with high concentrations of low-income housing) Yes No
Is the site compatible with surrounding land uses? Yes No
The adjacent properties include:
North______
South______
East______
West ______
Is the site located within a 100 year floodplain? (also known as a Special Flood Hazard Area [SFHA])
Yes No ATTACH a FEMA FIRM map ______[Map #, Panel #]
Are there any mitigating measures needed for the project?
Yes No These measures will include:______
Are there unusual drainage problems?
Yes No
Are there any mitigating measures needed for the project?
Yes No These measures will include:______
Is street access appropriate for the development? Yes No
Are the streets paved? Yes No Will the development also include paving? Yes No
Are there also curbs and gutters? Yes No Will the development include curb and gutters? Yes No
Are there any additional street improvements or mitigating measures needed for the project? (i.e.additional street lights, turn lanes, etc.) Yes No These additional improvements/measures will include______
______
Is the site located in reasonable proximity to facilities and services that may be utilized by the residents? Yes No
Describe the distance to the following locations:
Grocery Store______miles
Shopping______miles
Hospital______miles
Other Health Care Services______miles
Schools______miles
Day Care______miles
Parks______miles
The above mentioned site review was conducted by ______on ______(date).
CONCLUSION: Based on the site review, the Department has determined that the site is:
Approved, because the site is acceptable.
Approved with the following mitigation measures:______.
Not approved because the site is unacceptable based on______.
Not approved because the site is subject to re-inspection.
Not approved until the following mitigating measures can be agreed upon:______.
______
Signature Printed Name Date
Exhibit 104 Nebraska DED Site Review (updated Dec 2013)Page 1 of 2