20240462 Ver 1_Polk County - B13 - Architecture Assessment of Effects (3.1.24)_20240325

Project Tracking No. (Internal Use
23-07-0003
t HISTORIC ARCHITECTURE AND LANDSCAPES
LZ 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:
County:
Polk
WBSNo.:
BP14.R042.1
Document
Type:
MCC
Fed. Aid No:
Funding:
® State ❑ Federal
Federal
Permits :
® Yes ❑ No
Permit
T e s :
Project Description: Replace Bridge No. 13 over North Pacolet River on SR 1128 (Howard Gap
Road)
SUMMARY OF HISTORIC ARCHITECTURE 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 July 10, 2023. Based on this review, there is a National Register listed property
(Mill Farm Inn, PL0057) within the APE, which follows the boundary of the Study Area. An
assessment of effects is required.
ASSESSMENT OF EFFECTS
Property Name:
Mill Farm Inn
Status:
National Register Listed
Survey Site No.:
PL0057
PIN. -
Effects
❑ No Effect ® No Adverse Effect ❑ Adverse Effect
Explanation of Effects Determination:
There will be no adverse effect to the historic resource with the following environmental
commitments listed below.
List of Environmental Commitments:
The new bridge will utilize a two -bar metal rail.
Historic Architecture and Landscapes EFFECTS ASSESSMENT form for Minor Transportation Projects as Qualified in the 2007 Programmatic Agreement.
Page 1 of 3

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 BY NCDOT AND STATE HISTORIC PRESERVATION OFFICE
Historic Architecture and Landscapes — ASSESSMENT OF EFFECTS
—DocuSigned by:
NCDOT Architectural Historian
—DocuSigned by:
kmtt, JJQe d�r,� Q Q -F-(xA%
02/29/2024
Date
02/29/2024
State Historic Preservation Office Representative Date
—DocuSigned by:
(nsk QuLAS"Y
Federal Agency Representative
03/01/2024
Date
Historic Architecture and Landscapes EFFECTS ASSESSMENT form for Minor Transportation Projects as Qualified in the 2007 Programmatic Agreement.
Page 2 of 3

Design Plans for Polk Bridge No. 13
Historic Architecture and Landscapes EFFECTS ASSESSMENT form for Minor Transportation Projects as Qualified in the 2007 Programmatic Agreement.
Page 3 of 3