REQUEST FOR ALTERNATE PROJECT	Page of
DIRECTIONS: Complete each cell. Prepare a separate request for each project. Alternate projects must have consent by state, FEMA and have environmental and historic review prior to any construction before any funding can be approved.
DECLARATION NO. FEMA -DR-	PW NO.	FIPS NO.	DATE:	CATEGORY:
APPLICANT:	COUNTY:	DAMAGED FACILITY:
Applicant has determined that the public interest would not be best served by restoring this damaged facility. List below is an alternate project description and dimensions with detailed scope/schedule of work. Attached is the completed special considerations questionnaire. (Add attachments as necessary for a complete request description.)
COST ESTIMATE
ITEM	CODE	NARRATIVE	QUANTITY	UNIT	UNIT PRICE	COST
1.
2.
3.
4.
5.
TOTAL ESTIMATED COST OF ALTERNATE PROJECT: (Add attachment for details and/or additional line items)
SOURCE OF FUNDING FOR ADDITIONAL COSTS:
WORK TO BE PERFORMED BY: (Check one) A.) Contract B.) Applicant’s Employees and Equipment C.) Combination of A and B
ESTIMATED DATE OF COMPLETION WITH IMPROVEMENTS:
Applicant confirms by signature below that: 1) approval is based on the information provided with this request; 2) any changed conditions should immediately be brought to the attention of the Governor’s Authorized Representative; and. 3) approved alternate projects remain subject to all previous requirements for accountability, completion, and closure.
SIGNATURE OF APPLICANT’S AUTHORIZED REPRESENTATIVE:	DATE:
PRINT NAME AND POSITION:	CONTACT NUMBER:
APPROVAL SECTION (TO BE COMPLETED BY INDIANA DEPARTMENT OF HOMELAND SECURITY/RECOVERY/PA)
SIGNATURE OF STATE PUBLIC ASSISTANCE OFFICER:	DATE:

EHP COMPLIANCE – 7/14/06

All FEMA funded projects require Environmental/Historic Preservation (EHP) review and approval. Any project that changes the pre-disaster condition (function, capacity, or location) of a facility requires EHP review and approval PRIOR to the start of construction. Hazard mitigation, improved projects and alternate projects require a more detailed level of review because, by definition, they may involve a change in the function or capacity of a facility and/or work outside the footprint of the existing structure. The applicant is responsible for obtaining all required permits and complying with all conditions placed on the project.

If a proposed project:

Involves any action on beaches or in a CBRA zone

Is in or adjacent to floodplains, wetlands or water-ways

Changes the location or capacity of the damaged facility

Has the potential to affect any environmentally sensitive areas

Will involve excavation or digging in undisturbed ground

Is around any potentially historical sites or structures

Involves the repair or replacement of any structure more than 45 years old

The applicant must provide (as appropriate):

Site plans, drawings or sketches

Design/construction plans or drawings

Hydraulic/hydrological study or analysis

Location, site and floodplain (FIRM) maps

A record of any existing permits and permit applications

Copies of any existing permits and permit applications

Photographs of the damaged facility and the surrounding area

This information should be scanned or attached to the NEMIS file so that it is available to the EHP specialist during the review process. Projects submitted without the necessary back-up documentation cannot be processed through environmental review and approval without delays.

Also, in order to avoid unnecessary delays:

Provide clear damage description and scope of work

Do not combine multiple buildings or sites on a single PW

Note the date of construction of buildings and historic background

Provide overall photographic views of buildings and surroundings

Note and photograph any dedication or historical information plaques

Completely describe and locate the proposed site of replacement facilities

If this information is not included, processing will be delayed w

hile the scope is clarified, dates are establish and locations are determined.

It is especially important that the applicants provide the plans, maps, studies, photos, etc. and obtain the required permits/approval from the appropriate agencies PRIOR to the start of construction. Verification that all necessary permits have been obtained and all conditions have been met is required at project close-out. Failure to do so could jeopardize FEMA’s ability to fund the project.

Please contact the LTRO EHP staff if you have any questions. Thank you.

Rick Myers

Environmental Liaison Officer

Richard.myers@dhs.gov

(407) 858-2705 Office

(407) 251-9930 Fax