Form FHWA TCSP_2010 FHWA TCSP_2010 TCSP Grant Application

Attachment 2

This collection of information is voluntary and will be used to access the relationships among transportation, community, and system preservation plans and practices and identify private sector-based initiatives to improve such relationships. Public reporting burden is estimated to average 120 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. Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this collection is 2125-0615. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Highway Administration, 1200 New Jersey Avenue, SE, Washington, DC 20590.

TRANSPORTATION, COMMUNITY, AND SYSTEM PRESERVATION PROGRAM GRANT APPLICATION

PART A. PROJECT INFORMATION

Project Title:
Project Location (Include City/County, State):
GRANTEE CONTACT INFORMATION
Grantee Contact Name:
Agency:
Mailing Address (Street/P.O. Box):
City, State, Zip code:
Phone:
Fax:
E-Mail:
STATE DOT CONTACT INFORMATION
State Contact Person:
Phone:
Fax:
E-Mail:
FHWA DIVISION OFFICE CONTACT INFORMATION
Division Contact Person:
Phone:
Fax:
E-Mail:
CONGRESSIONAL INFORMATION
Congress Member:
Congressional District No.:
TCSP Program Funds:	$0.00
Matching Funds/In-kind Services Value:	$0.00
Matching Funds/In-kind Services Source:	$0.00
Total TCSP-Related Project Costs:	$0.00
TO BE COMPLETED BY THE FHWA DIVISION OFFICE
State Administered?		Yes		No
Division Administered?		Yes		No
“Transfer” TCSP funding for Project Administration?		Yes		No
If yes, which Federal Agency
Will the project be obligated by September 30, 2010?		Yes		No
Date grant application approved by FHWA Division Office

Part B. Project Abstract

(Maximum 4 sentences) Briefly describe the how the TCSP Program funds will be used to support the proposed project.

Part C. Project Narrative

• Describe the project and the expected results, including project goals and timeframe. Describe how the project integrates transportation, community, and system preservation plans and practices that address one or more of the following:

1. Improve the efficiency of the transportation system of the United States.

2. Reduce the impacts of transportation on the environment.

3. Reduce the need for costly future investments in public infrastructure.

4. Provide efficient access to jobs, services, and centers of trade.

5. Examine community development patterns and identify strategies to encourage private sector development that achieves the purposes identified in (1) through (4).

• If applicable, describe how the project meets all of the priority consideration criteria.

• Describe how the project meets the project selection criteria.

• Discuss the project schedule, commitment of public and private funding, and any other TCSP or other Federal funding being used for the project.

Part D. Project Eligibility

1. Is the project located on a Federal-aid highway? (List the functional class(es) of the facility(ies) to be improved)

2. If the project is not located on a Federal-aid highway, how do you consider the project eligible for assistance under Title 23 or Chapter 53 of Title 49, United States Code? (i.e., list program(s) and describe how the project meets the statutory eligibility criteria for that program.)

3. Is the project a corridor preservation activity necessary to implement transit-oriented development plans, traffic calming measures, or other coordinated transportation, community, and system preservation practices?

FORM – FHWA_TCSP2010

Updated: February 2, 2021 p. 3