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2011 Discretionary Grant Programs

Public Lands Highways Discretionary (PLHD) Program - Application

Download a Word version of this application: plhd2011appl.docx, 21 KB

PART A. PROJECT INFORMATION

Project Title:

Project Location (Include City/County, State):

State Priority (to be completed by State DOT):

GRANTEE CONTACT INFORMATION

Grantee Contact Name:

Federal Agency/Project Sponsor:

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.:


PLHD Program Funds Requested: $0.00 Leveraged Funds (if applicable): $0.00 Total Project Cost (includes funding request plus leveraged funds if applicable): $0.00

TO BE COMPLETED BY THE FHWA DIVISION OFFICE

State Administered? Yes No

Federal Lands Division Administered? Yes No

If yes, which Division?

Direct Allotment of PLHD funding to Federal Agency? Yes No

If yes, which Federal Agency?

Can the project be obligated by September 30, 2011? Yes No

Date grant application approved by FHWA Division Office

Part B. Project Abstract

(Maximum 5 sentences) Briefly describe the how PLHD Program funds will be used to support the proposed funding request.

Part C. Project Narrative

Part D. Project Eligibility

  1. Does the project within, adjacent to, or provide access to Tribal and/or Federal lands? Please identify which specific Public and/or Tribal land (i. e. Yellowstone National Park, Allegheny National Forest, BLM Lands, or Navajo Reservation).

  2. If the project does not meet the above criteria, on what basis do you consider this project eligible?

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