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Page 4 <br /> <br /> RELATED ACENCY ~NFOR~TION <br /> <br /> if any State ageney(s)~ Regional Planning Agency(s) or Local Govet'~ment ,tmit(s) <br /> have been contacted or have furnishedinformation relative to the proposed, list <br /> individual staff members contacted and agencies they represent: <br /> <br /> NRC0 Recreation Consultant ~ Robert Amos; Cabarrus and Salisbury <br /> <br /> Planning Departments - Dan Harley and Dan Johnson <br /> <br /> List any other State or local agencies which have an interest in or be affected <br /> by the proposed project: <br /> <br /> None <br /> <br /> Does the Federal Agency administering the program under which funding will be <br /> requested require an Environmental ~mpact Statement? YES x NO <br /> <br /> (If YES, attach a statement of the natur~ and extent of environmental impact anti- <br /> cipated). Attach additional sheets if necessary to present complete information, <br /> <br /> STATE}~NT OF CONCURRENCE <br /> <br /> I am fully aware that this pre-application will be used for pre-screening a Land <br /> and Water Conservation Fund for[]al application submission and concur with the <br /> information herein. I am also aware that any information found to be incorrect <br /> in this pre-application may jeopardize the progress of a 'formal application and <br /> potential funding of same. <br /> <br /> Name of Chief Elected Official James Lentz <br /> <br /> Title Chairman~ Cabarrus Board of <br /> County Con~nissioners <br /> Signature <br /> <br /> Date <br /> <br />Date Received (Regional Office) <br /> <br /> <br />