Preapplication Package for Planning Projects by vbd19928

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									                                                                                                                                                              Certified current 5/10/07
                                                                 2. DATE SUBMITTED                                             Applicant Identifier
APPLICATION FOR
FEDERAL ASSISTANCE
1. TY PE OF SUBMISSION:                                          3. DATE RECEIVED BY STATE                                     State Application Identifier


Application                            Preapplication            4. DATE RECEIVED BY FEDERAL AGENCY                            Federal Identifier
    Construction                           Construction
    Non-Construction                       Non-Construction
5. APPLICANT INFORMATION
Legal Name:                                                                                  Organizational Unit :
                                                                                             Department:
Organizational DUNS:                                                                         Division:

Address:                                                                                     Nam e and telephone num ber of person to be contacted on
Street:                                                                                      m atters involving this application (give area code)
                                                                                             Prefix:                        First Name:

City:                                                                                        Middle Name:

County:                                                                                      Last Name:

State:                                        Zip Code:                                      Suffix:

Country :                                                                                    Email:

6. EMPLOYER IDENTIFICATION NUMBER EIN):                                                      Phone number (give area code):                         FAX number (give area code):

               -
8. TY PE OF APPLICATION:                                                                     7. TYPE OF APPLICANT: (See back of form for Application Types)

                          New              Continuation        Rev ision
                                                                                             Other (specify)
If Rev ision, enter appropriate letter(s) in box(es):
(See back of f orm f or description of letters)                                              9. NAME OF FEDERAL AGENCY

Other (specify)
                                                                                             11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT:
10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER                                                       :

                                                          -
TITLE:


12. AREAS AFFECTED BY PROJECT (cities, counties, states, etc.):

13. PROPOSED PROJECT                                                                         14. CONGRESSIONAL DISTRICTS OF
                  Start Date                                  Ending Date                    a. Applicant                                             b. Project


15. ESTIMATED FUNDING                                                                        16. IS APPLICATION SUBJECT TO REVIEW BY STATE
                                                                                             EXECUTIVE ORDER 12372 PROCESS
a. Federal                     $                                            .00              a. Y es.           THIS PREAPPLICATION/APPLICATION WAS MADE AVAILABLE
                                                                                                                TO THE STATE EXECUTIVE ORDER 12372
b. Applicant                   $                                            .00                                 PROCESS FOR REVIEW ON

c. State                       $                                            .00
                                                                                                                DATE:

d. Local                       $                                            .00               b. No.            PROGRAM IS NOT COVERED BY E. O. 12372

e. Other                       $                                            .00                                 OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR
                                                                                                                REVIEW
f . Program income             $                                            .00
                                                                                             17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT ?

g. TOTAL                       $                                            .00
                                                                                                Y es        If “Y es” attach an explanation                               No
18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT, THE
DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE
ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED.
a. Authorized Representativ e
Prefix                                    First Name                                                                  Middle Name
Last Name                                                                                                             Suffix
b. Title                                                                                                              c. Telephone number (give area code)

d. Signature of Authorized Representative                                                                             e. Date Signed
Prev ious Editions Not Usable        Standard Form 424 (Rev .9-2003)
Authorized f or Local Reproduction   Prescribed by OMB Circular A-102
                                                      INSTRUCTIONS FOR THE SF 424


Public reporting burden for this collection of inform ation is estim ated to average 45 m inutes per response, including tim e for
review ing instructions, searching existing data sources, gathering and m aintaining the data needed, and com pleting and
review ing the collection of inform ation. Send com m ents regarding the burden estim ate or any o ther aspect of this collection of
inform ation, including suggestions for reducing this burden, to the Office of Managem ent and Budget, Paperw ork Reduction
Project (0348-0043), Washington, DC 20503.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED
BY THE SPONSORING AGENCY.


This is a standard form used by applicants as required facesheet for preapplications and applications submitted for Federal assistance. It will be used by Federal agencies to
obtain applicant certification that States which have established a review and comment procedure in response to Executive Order 12372 and have selected the program to be
included in their process, have been given an opportunity to review the applicant's submission.


Ite     Entry:                                                                         Item      Entry:
m
1.      Select Type of Submission.                                                     11.       Enter a brief descriptive title of the project. If more than one
                                                                                                 program is involved, you should append an explanation on a
                                                                                                 separate sheet. If appropriate (e.g. construction or real property
                                                                                                 projects), attach a map show ing project location.            For
                                                                                                 preapplications, use a separate sheet to provide a summary
                                                                                                 description of this project.
2.      Date application submitted to Federal agency (or State if                      12.       List only the largest political entities affected (e.g., State,
        applicable) & applicant's control number (if applicable).                                counties, cities).

3.      State use only (if applicable)                                                 13.       Enter the proposed start date and end date of the project.



4.      Enter Date Received by Federal Agency                                          14.       List the applicant's Congressional District and any District(s)
        Federal identifier number: If this application is a continuation or                      affected by the program or project.
        revision to an existing aw ard, enter the present Federal
        Identifier number. If for a new project, leave blank.
5.      Enter legal name of applicant, name of primary organizational                  15.       Amount requested or to be contributed during the first
        unit (including division, if applicable), w hich w ill undertake the                     funding/budget period by each contributor. Value of in-kind
        assistance activity, enter the organization’s DUNS number                                contributions should be included on appropriate lines as
        (received from Dun and Bradstreet), enter the complete address                           applicable. If the action w ill result in a dollar change to an
        of the applicant (including country), and name, telephone                                existing aw ard, indicate only the amount of the change. For
        number, e-mail, and fax of the person to contact on matters                              decreases, enclose the amounts in parentheses. If both basic
        related to this application.                                                             and supplemental amounts are included, show breakdow n on an
                                                                                                 attached sheet. For multiple program funding, use totals and
                                                                                                 show breakdow n using same categories as item 15.
6.      Enter Employer Identification Number (EIN) as assigned by the                  16.       Applicants should contact the State Single Point of Contact
        Internal Revenue Service.                                                                (SPOC) for Federal Executive Order 12372 to determine w hether
                                                                                                 the application is subject to the State intergovernmental review
                                                                                                 process.
7.      Enter the appropriate letter                                                     17.      This question applies to the applicant organization, not the
        in the space provided.             I.       State Controlled                              person w ho signs as the authorized representative. Categories
        A.     State                                Institution of Higher                         of debt include delinquent audit disallow ances, loans and taxes.
        B.     County                               Learning
        C.     Municipal                   J.       Private University
        D.     Tow nship                  K.        Indian Tribe
        E.     Interstate                 L.        Individual
        F.     Intermunicipal             M.        Profit Organization
        G.     Special District           N.        Other (Specify)
        H.     Independent School         O.        Not for Profit Organization
                District
8.      Select type from the follow ing list:                                          18.       To be signed by the authorized representative of the applicant. A
                                                                                                 copy of the governing body's authorization for you to sign this
             "New " means a new assistance aw ard.                                              application as official representative must be on file in the
             "Continuation" means an extension for an additional                                applicant's office. (Certain Federal agencies may require that this
              funding/budget period for a project w ith a projected                              authorization be submitted as part of the application.)
              completion date.
             "Revision" means any change in the Federal Government's
              financial obligation or contingent liability from an existing
              obligation. If a revision enter the appropriate letter:
                 A. Increase Aw ard     B. Decrease Aw ard
                 C. Increase Duration D. Decrease Duration
9.    Name of Federal agency from w hich assistance is being
      requested w ith this application.
10.   Use the Catalog of Federal Domestic Assistance number and
      title of the program under w hich assistance is requested.
                                                                   SF-424 (Rev. 7-97) Back
                                                              PART IV
                                                         PROGRAM NARRATIVE
                                                                      (Suggested Format)

U.S. DEPARTMENT OF TRANSPORTATION - FEDERAL AVIATION ADMINISTRATION                        OMB NO. 2120-0569

PROJECT:
AIRPORT:
1. Objective:




2. Benefits Anticipated:




3. Approach: (See approved Scope of Work in final Application)




4. Geographic Location:




5. Justification for Force Account Work: (if applicable)




6: Sponsor's Representative: (incl. address & tel. no.)




FAA Form 5100-100 (6-73) SUPERSEDES FAA FORM 5100-10 PAGES 1 THRU 7                                    PAGE 6
                                                                   INSTRUCTIONS
                                                                      PART IV
                                                                PROGRAM NARRATIVE

Prepare the program narrative statement in accordance w ith the follow ing instructions for all new grant programs. Requests f or supplemental
assistance should be responsive to Item 5b only. Requests for continuation or refunding or other changes of an approved project should be
responsive to Item 5c only.

1. OBJECTIVES AND NEED FOR THIS ASSISTANCE.                                  4. GEOGRAPHIC LOCATION.

Pinpoint any relevant physical, economic, social, financial,                 Give a precise location of the project and area to be served by the
institutional, or other problems requiring a solution.                       proposed project. Maps or other graphic aids may be attached.

Demonstrate the need for assistance and state the principal and              5. IF APPLICABLE, PROVIDE THE FOLLOWING INFORMATION:
subordinate objectives of the project. Supporting
documentation or other testimonies from concerned interests                  a. Describe the relationship betw een this project and other w ork
other than the applicant may be used. Any relevant data                      planned, anticipated, or underw ay under the Federal Assistance
based on planning studies should be included or footnoted.                   listed under Part II, Section A, Item 10.

2. RESULTS OR BENEFITS EXPECTED.                                             b. Explain the reason for all requests for supplemental assistance
                                                                             and justify the need for additional funding.
Identify results and benefits to be derived. For example,
include a description of w ho w ill occupy the facility and show             c. Discuss accomplishments to date and list in chronological order a
how the facility w ill be used. For land acquisition or                      schedule of accomplishments, progress or milestones anticipated
development projects, explain how the project w ill benefit the              w ith the new funding re-quest. If there have been significant
public.                                                                      changes in the project objectives, location, approach or time delays,
                                                                             explain and justify. For other requests for changes or amendments,
3. APPROACH                                                                  explain the reason for the change(s). If the scope or objectives
                                                                             have changed or an extension of time is necessary, explain the
a. Outline a plan of action pertaining to the scope and detail of            circumstances and justify. If the total budget has been exceeded or
how the proposed w ork w ill be accomplished for each grant                  if individual budget items have changed more than the prescribed
program. Cite factors w hich might accelerate or decelerate                  limits contained in Attachment K, Office of Management and Budget
the w ork and your reason for taking this approach as                        Circular No. A-102, explain and justify the change and its effect on
opposed to others. Describe any unusual features of the                      the project.
project such as design or technological innovations,
reductions in cost or time, or extraordinary social and
community involvements.

b. Provide each grant program monthly or quarterly
quantitative projections of the accomplishments to be
achieved, if possible. When accomplishments cannot be
quantified, list the activities in chronological order to show the
schedule of accomplishments and their target dates.

c. Identify the kinds of data to be collected and main-tained,
and discuss the criteria to be used to evaluate the results and
success of the project. Explain the methodology that w ill be
used to determine if the needs identified and discussed are
being met and if the results and benefits identified in Item 2 are
being achieved.

d. List each organization, cooperator, consultant, or other key
individuals w ho w ill w ork on the project along w ith a short
description of the nature of their ef fort or contribution.
                                            REQUIRED STATEMENTS
                                  AIRPORT IMPROVEMENT PROGRAM PROJECTS

AIRPORT:

LOCATION:

AIP PROJECT NO.:

STATEMENTS APPLICABLE TO THIS PROJECT

       a.   INTEREST OF NEIGHBORING COMMUNITIES: In formulating this project, consideration has been given to
            the interest of communities that are near (Exact name of airport) .

       b.   THE DEVELOPMENT PROPOSED IN THIS PROJECT will not require the use of publicly owned land from a
            public park, recreation area, wildlife and fowl refuge, or a historical site under Federal, State, or Local
            jurisdiction.

       c.    FBO COORDINATION: The airport development proposed in this project has been coordinated      with the
            Fixed Base Operator(s) utilizing (Exact name of airport) , and they have been informed regarding the
            scope and nature of this project.

       d.   THE PROPOSED PROJECT IS CONSISTENT with existing approved plans for the area surrounding the airport.

The above statements have been duly considered and are applicable to this project. (Provide comment for any statement
not checked).


                              BY:                                   DATE:

                          TITLE:

      SPONSORING AGENCY:

NOTE: Where opposition is stated to an airport developm ent project, w hether expressly or by proposed revision, the follow ing
specific inform ation concerning the opposition to the project m ust be furnished.



 a.     Identification of the Federal, state, or local governmental agency, or the person or persons opposing the project;

 b.     The nature and basis of opposition;

 c.     Sponsor's plan to accommodate or otherw ise satisfy the opposition;

 d.     Whether an opportunity for a hearing w as afforded, and if a hearing w as held, an analysis of the facts developed at the hearing as they
        relate to the social, economic, and environmental aspects of the proposed project and its consistency w ith the goals and objectives of
        such urban planning as has been carried out by the community.

 e.     If the opponents proposed any alternatives, w hat these alternatives w ere and the reason for nonacceptance;

 f.     Sponsor's plans, if any, to minimize any adverse effects of the project;

 g.     Benefits to be gained by the proposed development; and

 h.     Any other pertinent information w hich w ould be of assistance in determining w hether to proceed w ith the project.

								
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