North Carolina DOT Community Impact Assessment Checklist

PROJECT INFO

TIP No.___________    State Project No.________________    County_____________

Brief project description:



PURPOSE

What is the purpose of this project? Circle all that apply:

Reduce congestion        Improve vehicle/driver safety        System linkage/network

Economic development        Improve bicycle/pedestrian capacity or safety

Change to current design standards     Other_______________



COMMUNITY FACILITIES

Are there any of the following facilities within 1/4 mile of the proposed project?
Circle all that apply:

School     Park     Hospital     Fire Station    Community/Rec Center

Church        Bank        Transit Stop        Police Station    Public Housing

Grocery        Library        Laundromat        Senior Center    Community Pool

Other Cultural Resource (town gathering spot, historic building / monument)
Please describe:




ACCESS

Will the project alter access to any of the community facilities described above?

For vehicles            Yes        No    Don’t Know
(e.g. driveway changes / restrictions, introduction of median, create severed road/cul-de-sac)

For pedestrians/cyclists/other non-auto             Yes        No    Don’t Know
(e.g. jersey barrier, channeling to crossing, create severed road/cul-de-sac)

If Yes for either question, please describe



Will the project impact driveways / parking lots?        Yes        No     Don’t Know

Will the project impact emergency access?        Yes        No     Don’t Know

Is there a bus/transit stop located along the project?        Yes        No
(The local planner / transit authority can assist on this and the next question)

How will the project change the availability or convenience of obtaining transit services?

Increase        Decrease        Stay the same        Don’t Know



COMMUNITY CHARACTERISTICS

The project area consists primarily of:

Residential         Commercial        Industrial

Please provide a brief description of the area.

(e.g. cohesive older residential, with a few commercial uses, such as a drug store)

Does the area surrounding the project appear to be low income?        Yes     No    Don’t Know*

Does the area around the project appear to have minority populations?        Yes    No    Don’t Know*

Members of the following populations observed.        Circle all that apply

African-American     Asian     Hispanic    Native American     Other________   Don’t Know*

Does the project area have a considerable number of individuals from the following populations?

Elderly     Children     Disabled    Don’t Know*

Describe the level of pedestrian activity in the area.

High        Medium     Low    Don’t Know*

Is there bicycle activity in the area?      Yes    No    Don’t Know*



COMMUNITY COHESION

Will the project require relocation of the following?
Circle all that apply and indicate number affected

Residences        Businesses        Cemetery / graves

Community Facilities (specify)        Don’t Know

Will the project create a barrier / divide an area / neighborhood?           Yes    No    Don’t Know
(create gaps by taking homes, introduce structural barriers such as bridges, jersey barriers, noise walls)

*Not enough information to make a determination due to not being in the field at the time which this information could be observed or other timing issue.



PEDESTRIAN/BICYCLE SAFETY

Are there currently sidewalks along the facility?        Yes        No   N/A (new loc.)

Proposed as a part of the project?        Yes        No       Don’t Know

Are there currently bike lanes / paths?        Yes        No      N/A

Proposed as a part of the project?            Yes     No    Don’t Know

Does the project include widening the road?                Yes    No   N/A

Will the project include a median to provide a crossing island refuge?        Yes    No    Don’t Know

How will the speed limit be changed?             Increase    Decrease    Stay the same

Proposed speed limit _____mph

Describe other project features that may improve or decrease pedestrian / bicycle safety in the area.
(e.g. crosswalks, pedestrian signals, separation of road and sidewalk, driveway restrictions)



VISUAL IMPACTS

Are there large / mature trees located close to the existing road?                 Yes        No

Will the project maintain or remove existing plantings?                Maintain Remove    Don’t Know

Is there development (houses, businesses) close to the existing road?                Yes        No

Will the project include a median?                Yes        No

Will the median be landscaped?                Yes        No

What is terrain like?                Flat      Rolling     Mountainous

Does the project include any roads designated as scenic byways?                Yes        No



OTHER

Are there dense residential clusters that may need noise analysis?                Yes        No

Will the project cross over or closely parallel a rail line?             Yes        No

If Yes, describe the configuration and proximity to the rail line

If residents approached you with questions or if there are existing
community issues not touched on by this survey, please briefly describe: