Download a Word version of this application: tcsp2012appl.docx, 22 KB
Project Title:
Project Location (Include City/County, State):
State Priority (to be completed by State DOT):
GRANTEE CONTACT INFORMATION
Grantee Contact Name:
Agency/Tribal Government:
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, 2011? Yes No
Date grant application approved by FHWA Division Office
(Maximum 4 sentences) Briefly describe the how the TCSP Program funds will be used to support the proposed project.
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:
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.