Only one project sponsor is allowed per project. As a representative of the project sponsor, the individual that signs below confirms that the information in this project application is accurate. A local official, not a consultant, must sign the application. I understand that completion of this application does not guarantee project approval for federal funding. Head of Government/Designee Signature (electronic only): Date: Application and Attachments Submit applications and attachments utilizing the contact information contained in the corresponding CMAQ Program Application Instructions. Eligible applications must be and postmarked on or before June 15, 2017, must include the following documents: A completed application in Microsoft Word format Narrative Response: limited to three double-spaced pages of minimum 11-point font size and in Microsoft Word format. Cost Estimate Detail as required in the Project Costs and Dates section of this application in Microsoft Excel format Project map: printed in black & white, on one sheet of paper size 8½ X 11 Optional attachment(s): no more than six of project description, additional photos, and maps WisDOT Information Shaded area to be completed by WisDOT staff only. – FOR WISDOT USE ONLY enter the following information at application review – NOTE: Please add any WisDOT application comments in the comments section on the Confidential page A-5. Subprogram: Project Improvement Type: Anticipated Environmental Document Type (e.g., programmatic, ER, EA, EIS): Region Reviewer’s Name: Reviewer’s Title: Date Received: WisDOT Region Reviewer’s Signature: Date:
Only one project sponsor is allowed per project. As a representative of the project sponsor, the individual that signs below confirms that the information in this project application is accurate. A local official, not a consultant, must sign the application. I understand that completion of this application does not guarantee project approval for federal funding. Head of Government/Designee Signature (electronic only): Date: Application and Attachments Submit applications and attachments utilizing the contact information contained in the corresponding CMAQ Program Application Instructions. Eligible applications must be postmarked on or before June 15, 2017, and must include the following documents: A completed application in Microsoft Word format Narrative Response: limited to three double-spaced pages of minimum 11-point font size and in Microsoft Word format. Cost Estimate Detail as required in the Project Costs and Dates section of this application in Microsoft Excel format Project map: printed in black & white, on one sheet of paper size 8½ X 11 Optional attachment(s): no more than six of project description, additional photos, and maps WisDOT Information – Shaded area to be completed by WisDOT staff only. FOR WISDOT USE ONLY – enter the following information at application review NOTE: Please add any WisDOT application comments in the comments section on the Confidential page A-5. Subprogram: Project Improvement Type: Anticipated Environmental Document Type (e.g., programmatic, ER, EA, EIS): Region Reviewer’s Name: Reviewer’s Title: Date Received: WisDOT Region Reviewer’s Signature: Date:
cmaq-app.docx