20210481 Ver 1_15-03-0019EffectsUPDATE_20210304

Project Tracking No.(Internal Use
15-03-0019
UPDATE
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
Project No: B-5416 County: Perquimans
WBSNo.: 55046.1.1 • . • Document PCE
Type:
Fed.Aid No: N/A Funding: ® State ❑ Federal
Federal ® Yes ❑ No Permit NWP
Permit(s): Type(s):
Project Description:
Replace Bridge No. 29 on SR 1200 (Bethany Church Road/Perry's Bridge Road) over a branch
of the Perquimans River.
SUMMARY OF HISTORIC ARCHICTECTURE AND LANDSCAPES REVIEW
Description of review activities, results, and conclusions:
Review of HPO quad maps, HPO GIS information, historic designations roster, and indexes was
undertaken on March 10, 2015. The Determined Eligible Thomas D. White House (PQ295) is
within the Area of Potential Effects, which is approximately 800' from each end of the bridge
and 150'from the centerline each way.
ASSESSMENT OF EFFECTS
Property Name: Thomas D. White House Status: Determined Eligible
Survey Site No.: PQ295 PIN: 7934-30-6780
Effects
❑ No Effect No Adverse Effect ❑ Adverse Effect
Explanation of Effects Determination:
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List of Environmental Commitments:
Historic Architecture and Landscapes EFFECTS ASSESSMENT form for Minor Transportation Projects as(notified in the 2007 Programmatic Agreement.
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FHWA Intends to use the State Historic Preservation Office's concurrence as a basis for a "de
minimis" finding for the following properties, pursuant to Section 4(f):
SUPPORT DOCUMENTATION
❑Map(s) ❑Previous Survey Info. [Photos ❑Correspondence Design Plans
FINDING-B-Y-NODO-T AND-ST-ArE HISTORIC-PRESERV-A-T-ION OFFICE
Historic Architecture and Landscape —ASSESSMENT OF EFFECTS
l3a12-0lq.
NCDOT Architectural Historian Date
L.02- )J3X.Wita
State Historic Preservation Office Rep?act
ive Date
Federal Agency Representative Date
Historic Architecture and Landscapes EFFECTS ASSESSMENT form for Minor Transportation Projects as Qualified in the 2007 Programmatic Agreement.
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