HomeMy WebLinkAbout2016-052 Request for Release of Funds U.S. Department of Housing OMB No.2506-0087
and Urban Development (exp 07/31/2017)
and Certification Office of Community Planning
and Development
This form is to be used by Responsible Entities and Recipients (as defined in 24 CFR 58.2)when requesting the release of funds, and
requesting the authority to use such funds,for HUD programs identified by statutes that provide for the assumption of the environmental
review responsibility by units of general local government and States. Public reporting burden for this collection of information is estimated
to average 36 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. This agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number
Part 1. Program Description and Request for Release of Funds (to be completed by Responsible Entity)
1 Program Title(s) 2. HUD/State Identification Number 3. Recipient Identification Number
Florida Small Cities Community Development Block Grant 16DB-OK-10-40-01-N05 (optional)
4 OMB Catalog Number(s) 5. Name and address of responsible entity
CFDA NO 14.218 Indian River County
6 For information about this request,contact(name&phone number) 1801 27th Street
Arjuna Weragoda; Tel . 772-226-1821 Vero Beach, Florida 32960
8. HUD or State Agency and office unit to receive request 7 Name and address of recipient(if different than responsible entity)
Florida Department of Economic Opportunity N/A
The recipient(s)of assistance under the program(s) listed above requests the release of funds and removal of environmental
grant conditions governing the use of the assistance for the following
9 Program Activity(ies)/Project Name(s) 10 Location(Street address,city,county, State)
Service Area 1-boundary streets are in the area south of 510 between 64th Ave and
West Wabasso Phase 2 New Sewer Mains and
62nd Ave. Service Area 2-general location is in the East Gifford area between 28th Ave.
New Sewer Hookups/ Gifford Flood and Drainage to the west,Old Dixie Hwy to the east,43rd st.42nd St.,encompassing 42nd PI,27th
Ave.,26th Ave.,25th Ave.,24th Ct.and 24th Ave.
11 Program Activity/Project Description
The project includes Phase II of the West Wabasso new sewer mains, 16 manholes and laterals and up to a possible 45 sewer
hook ups A complimentary benefit will be the reconstruction of streets and paving to modern standards The Gifford Flood
and Drainage improvement project includes improving swales and new culverts in the East Gifford area. These re-graded
swales and new culvert pipes will convey stormwater flows to the existing wet detention pond located south of 42nd Street.
Activity CDBG
New Sewer Mains $720,000
New Flood and Drainage $30,000
Total CDBG Budget $750,000
Previous editions are obsolete form HUD-7015.15(1/99)
Part 2. Environmental Certification (to be completed by responsible entity)
With reference to the above Program Activity(ies)/Project(s), 1, the undersigned officer of the responsible entity, certify that:
I The responsible entity has fully carried out its responsibilities for environmental review, decision-making and action pertaining
to the project(s)named above
2 The responsible entity has assumed responsibility for and complied with and will continue to comply with,the National
Environmental Policy Act of 1969, as amended, and the environmental procedures, permit requirements and statutory obligations
of the laws cited in 24 CFR 58.5, and also agrees to comply with the authorities in 24 CFR 58 6 and applicable State and local
laws
3. The responsible entity has assumed responsibility for and complied with and will continue to comply with Section 106 of the National
Historic Preservation Act,and its implementing regulations 36 CFR 800, including consultation with the State Historic Preservation
Officer, Indian tribes and Native Hawaiian organizations,and the public.
4. After considering the type and degree of environmental effects identified by the environmental review completed for the proposed
project described in Part i of this request, I have found that the proposal did ❑ did not Z require the preparation and
dissemination of an environmental impact statement.
5. The responsible entity has disseminated and/or published in the manner prescribed by 24 CFR 58 43 and 58.55 a notice to the public
in accordance with 24 CFR 58.70 and as evidenced by the attached copy(copies)or evidence of posting and mailing procedure
6 The dates for all statutory and regulatory tune periods for review, comment or other action are in compliance with procedures and
requirements of 24 CFR Part 58
7 In accordance with 24 CFR 58.71(b),the responsible entity will advise the recipient(if different from the responsible entity)of
any special environmental conditions that must be adhered to in carrying out the project.
As the duly designated certifying official of the responsible entity, I also certify that
8. 1 am authorized to and do consent to assume the status of Federal official under the National Environmental Policy Act of 1969
and each provision of law designated in the 24 CFR 58 5 list of NEPA-related authorities insofar as the provisions of these laws
apply to the HUD responsibilities for environmental review,decision-making and action that have been assumed by the responsible
entity
9. 1 am authorized to and do accept,on behalf of the recipient personally,the jurisdiction of the Federal courts for the enforcement
of all these responsibilities, in my capacity p 0&0 Icerof the responsible entity
.s`
Signature of Certifying Officer of the ResponsibteWfit y��,• Title of Certifying Officer
Chairman, BOCC Indian River County
Date signed
X 'y' =ir�t?= April 12, 2016
Address of Certifying Officer •'••.,C0UlirtJ••'•
1801 27th Street,Vero Beach Florida 32960
Part 3.To be completed when the Recipient is not the Responsible Entity
The recipient requests the release of funds for the programs and activities identified in Part 1 and agrees to abide by the special
conditions,procedures and requirements of the environmental review and to advise the responsible entity of any proposed change in
the scope of the project or any change in environmental conditions in accordance with 24 CFR 58.71(b).
Signature of Authorized Officer of the Recipient Title of Authorized Officer
Date signed
X
Warning HUD will prosecute false claims and statements.Conviction may result in criminal and/or civil penalties.(18 U S C 1001, 1010, 1012;31 U S C
3729,3802)
A=ST
Jeffrey R. smith, Clerk of Court and Ccmptroller form HUD-7015.15(1/99)
Terri Ccillins-Lister, Deputy Clerk