Public Lands Highway Discretionary

FY 2010 Project Application

(Short Form for Projects Designated by Congress)

Word Version (25 kb)

1. State:

2. County:

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

4. U.S. Congressional District Member's Name(s):

5. Project Designation (Title):

6. Project Location:

7. Proposed Work:

8. How is this project eligible and specifically what Federal Lands or facilities is this project serving?

9. Project Purpose & Benefits:

10. Project Administration:

11. Amount of Federal PLH Discretionary Funds Earmarked:

12. If additional funding above the earmarked amount is available…

    1. What is the total additional amount needed above the earmark to complete all phases?
    2. Assuming funding is available on July 1st, how much could be obligated in fiscal year 2010 for designated project only? What project milestone would this achieve?

13. Project Schedule: