Form FHWA DRTDP_2010 FHWA DRTDP_2010 DRTDP Grant Application

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 90 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.

DELTA REGION TRANSPORTATION DEVELOPMENT PROGRAM

FY 2010 PROJECT APPLICATION

1. State:

2. State priority:

3. County:

4. U.S. Congressional District No.(s):

5. U.S. Congressional District Member’s Name(s):

6. Project Name:

7. Project Location:

8. Functional class of the facility(ies) to be improved:

9. Project narrative:

10. Amount of FY09 DRTDP funds available for this project =

11. Amount of State matching funds to be provided =

12. Can the project be obligated by September 30, 2009?

APPLICATION NOTES

1. State in which the project is located.

2. State Priority - Indicate what priority this project is for the State of the applications submitted; i.e. Number 1 priority of 4 applications submitted.

3. County in which the project is located.

4. U.S. Congressional District No.(s) in which the project is located. This is the U.S. Congressional District not the State legislature district.

5. U.S. Congressional District Member's Name(s). This is the U.S. Congressional District representative, not the State legislature representative.

6. Project Name – use the same project name shown in the Joint Explanatory Statement accompanying the Consolidated Appropriations Act of 2009 (see attachment 1).

7. Project Location - Describe the specific location of the project, including route number and termini, if applicable. Also include the appropriate local jurisdiction(s) in which the project is located.

8. Functional Class – List the functional class of the facilities to be improved. (Note: DRTDP projects must be located on a Federal-aid highway. The term ``Federal-aid highway'' means a highway other than a highway classified as a local road or rural minor collector.)

9. Project Narrative – Describe the project and the expected results, including project goals and time frame.

10. Amount of FY09 DRTDP funds available for this project

11. Amount of State matching funds to be provided

12. Can the project be obligated this fiscal year? Funds will only be allocated this fiscal year to projects that are ready to be obligated.

FORM – FHWA_DRTDP2010