760005: Determination of Effects Form for Local Agencies

Iowa DOT

Forms.Management@iowadot.us

Print Document

When you click Print below we will prepare a printable document for you. It will automatically download when it's ready.

Did you know?
You can fill in the document online and then click the print icon and all of your information will be populated in the printable document, saving you time later.

SeamlessDocs

What habitats are present in the project area? Check all that apply. Attach photos of each.

Determination of Effect for Threatened & Endangered Species For Local Public Agencies

PROJECT EVALUATION

Determine what species to look for: Check IADNR and USFWS websites. Attach findings.

Review habitat characteristics as described on IA DNR and USFWS websites for each species.Is there suitable habitat for protected species present in the project area?

Review

Will the project impact suitable habitat for protected species? Ensure all feasible options to avoid impacting suitable habitat are pursued.

If Yes, what species/species habitats will be impacted? Move on to the next question.

Are there measures that can be taken to minimize potential impacts to species/habitat?

Determination

References

disregard this

Create Your Signature

Please fill in your name and email and then either draw or type your signature below.

Full Legal Name

Your Initials

Signature Type

Type Draw Upload Custom

Clear Signature

Signature will be applied to the page. You will have a chance to review after signing.

Check this box to continue

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Additional Signatures Required

Sign Now!

Please provide accurate information below to ensure the delivery of the signed copies of the document.

Legal Full Name (as you would sign):

Valid Email Address: