20180284 Ver 1_16-03-0033_EffectsSigned_20180226

Project No:
WBS No.:
Fed. Aid No:
Project Tracking No. (Intetmal Use)
16-03-0033
HISTORIC ARCHICTECTURE AND LANDSCAPES
ASSESSMENT OF EFFECTS FORM
This form only pertains to Historic Architecture and Landscapes for this project. It
is not valid for Archaeological Resources. You must consult separately with the
Archaeology Group.
PROJECT INFORMATION
B-5771 County: Forsyth
45727.1.1
Federal I IXI Yes I_ _ 1 No
Document I MCC
Funding:
Permit
Yermit(s): � I IYPe(sl � I
Proiect Descrintion:
Replace Bridge No. 16 on SR 1611 (Main St) over Muddy Creek.
State I J Federal
�C►+.�l�c3
SUMMARY OF HISTORIC ARCHICTECTURE AND LANDSCAPES REVIEW
Description of review activities, results, and conclusions:
On July 13, 2016 a search of NC HPOWEB GIS Service map found that the bridge replacement
is within the National Register listed Bethania Historic District (FY2044).
ASSESSMENT OF EFFECTS
Property Name: Bethania Historic District Status: NR
Survey Site No. : FY2044 PIN.•
Effects
❑ No Effect � No Adverse Effect ❑ Adverse Effect
Exnlanation of Effects Determination:
The replacement of Forsyth Bridge No. 16 will not have an adverse effect on any of the eligible
structures or the viewshed from those structures within the Bethania Historic District (FY2044).
Hlsloric Archileclure and Landscapes EFFF.CTS ASSESSMENT form for Mrnor Transportatran Projecis as Qualifred in Ihe 2007 Programmatic Agreemenl.
Page 1 of 5

List ofEnvironmental Commitments:
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FINDING BY NCDOT AND STATE HISTORIC PRESERVATION OFFICE
Historic Architecture and Landscapes -ASSESSMENT OF EFFECTS
NCDOT Architectur�l Historian � Date
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State Historic Preservation Office Representative V Date
Historic Architecture and Landscape.r F.FFECTS ASSESSMF.NTfa•m for Mina• Transpor(alron Projec�s as Qualified rn Ihe 2007 Progra�mnalrc Agreement.
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