Transportation, Community, and System Preservation Program Grant Application

Part A. Project Information

GRANTEE CONTACT INFORMATION
Project Title:
Project Location (Include City/County, State):

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:
Total TCSP-Related Project Costs:	$0.00

TO BE COMPLETED BY THE 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 for the 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

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

If you have any questions regarding the Transportation, Community, and System Preservation Program, please contact Gary Jensen at gary.jensen@dot.gov or Wesley Blount at wesley.blount@dot.gov.