NSFLTP 24_26 application template.docx

Fiscal Years 2024 through 2026 Nationally Significant Federal Lands and Tribal Projects Program Application Template

This is the Application Template for Fiscal Years (FY) 2024 through 2026 Nationally Significant Federal Lands and Tribal Projects (NSFLTP) Program.

Submission of this Application Template is required as part of a complete application package. The Application Template, in conjunction with the allowable attachments and standard forms, must provide all information necessary for the U.S. Department of Transportation (DOT), Federal Highway Administration (FHWA) to determine if the project meets the eligibility requirements described in Notice of Funding Opportunity (NOFO) Section B and to evaluate the criteria specified in NOFO Section F. DOT will consider applications submitted without the completed template as incomplete and will not review the submission. DOT encourages applicants to review the NOFO in its entirety to ensure that their project is eligible and includes all required information and documentation.

Expand the response blocks as necessary but limit the total application template to a total of 20 pages not including attachments. [Applicants: Delete instructions shown below in italic prior to submittal.]

I. Summary

Project Name:

Eligible Entity Applying to Receive Federal Funding:

Entity Type:

(Entity types marked with an * must attach a sponsor letter from an eligible federally recognized Indian Tribe or FLMA. See Section B of the NOFO for more details) ☐ Tribal Government ☐ Federal Land Management Agency (FLMA) ☐ County or unit of local government* ☐ State*

State(s) in which the project is located:

Project Abstract: Summarize project work to be completed under the project and succinctly describe how the NSFLTP funds would be used to complete the project.

Attachments: Please list any attachments to this form, including letters of support. This includes any applicable State Department of Transportation support letters as described in Section B.4 of the NOFO.

II. Project Information

(The facility does not need to be included in an inventory described in 23 United States Code (U.S.C.) Sections 202 or 203.)

☐ Federal lands transportation facility[footnoteRef:1] [1: A Federal lands transportation facility means a public highway, road, bridge, trail, or transit system that is located on, is adjacent to, or provides access to Federal lands for which title and maintenance responsibility is vested in the Federal Government (23 U.S.C. 101(a)(8)). ]

☐ Federal lands access transportation facility[footnoteRef:2] [2: A Federal lands access transportation facility means a public highway, road, bridge, trail, or transit system that is located on, is adjacent to, or provides access to Federal lands for which title or maintenance responsibility is vested in a State, county, town, township, Tribal, municipal, or local government (23 U.S.C. 101(a)(7)). ]

☐ Tribal transportation facility[footnoteRef:3] [3: A Tribal transportation facility means a public highway, road, bridge, trail, or transit system that is located on or provides access to Tribal land (23 U.S.C. 101(a)(33)).]

☐ None of the above

(see NOFO Section B) ☐ Yes-Record of Decision ☐ Yes-Finding of no significant impact ☐ Yes-Determination that categorically excluded ☐ No

III. Budget and Funding

Other Federal programs and estimated amounts: (add lines as needed) Program: _________________Amount: ____________

Other non- Federal programs and estimated amounts: (add lines as needed) Program: _________________Amount: ____________

Amount: $____________

☐ A detailed budget is attached separately. The file is named:

Activity: Cost:

Activity: Cost:

Activity: Cost:

Activity: Cost:

☐ A detailed budget is attached separately. The file is named:

IV. Merit Criteria

In the space below, describe how the project will meet the merit criteria, and the associated objectives as found in Section F of the FYs 2024 through 2026 NSFLTP NOFO. Where appropriate, reference attachments or other sections of the application.

Criterion #1: Statutory Selection Criteria § 1123(f)(1)-(3) of the FAST Act and in support of Addressing Core Infrastructure, Economic Competitiveness and Reinvesting in the American Family

Criterion #2: Statutory Selection Criteria § 1123(f)(6) of the FAST Act and in support of Innovation

Criterion #3: Statutory Selection Criteria § 1123(f)(4), (5) and (7)-(9) of the FAST Act

V. Project Readiness

In the space below, describe how the project will meet the Readiness Considerations and the associated elements as found in Section F of the FYs 2024 through 2026 NSFLTP Program NOFO. Where appropriate, reference attachments or other sections of the application.

Readiness: Technical Assessment

Readiness: Financial Completeness Assessment

Readiness: Permitting Risk Assessment

VI. DOT Priority Considerations

In the space below, describe how the project will meet the DOT priority considerations in Section F of the FYs 2024 through 2026 NSFLTP NOFO. Where appropriate, reference attachments or other sections of the application.

DOT Priority Considerations: Briefly describe below how the project responds to the following DOT priority considerations from Section F of the FYs 2024 through 2026 NSFLTP NOFO:

· DOT may provide awards to projects that decrease roadway traffic congestion without proposing limits on roadway capacity for motor vehicles or creating artificial chokepoints for motor vehicles.

· DOT may provide awards to projects that show a high responsiveness to reinvesting in the American family through beautification of transportation infrastructure, improvements to the travel experience for American families, or expansion or modernization of transportation in rural communities.

FHWA will determine responsiveness to the other DOT priority considerations based on the application readiness assessment and past awards.