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'.'JOT 29222 IS 77) <br />MINNESOTA DEPARTMENT OF TRANSPORTATION <br />PRELIMINARY BIKEWAY GRANT APPLICATION <br />,,[ructions: <br />1. Please type or print in ink (use ball-point pen), except for applicant's signature. <br />?. Directions for mailing on reverse side o f yello w copy. I <br />I. This preliminary grant application must be submitted by — , I to be considered for F.Y. 1.9 <br />1rf,\1A/NjESOT4 <br />i- <br />D <br />O <br />T OF TFPt� <br />Preliminary grant application for financial assistance in local bikeway development. Date request received <br />IM.S. 1977, Ch. 421) _ <br />Minnesota Department of Transportation <br />Bureau of Policy and Planning <br />Office of Environmental Affairs (Bike Program) <br />820 Transportation Building <br />St. Paul, MN 55155 <br />Do Not Write Above This Line <br />A Political subdivision responsible for project: [2_j Person to whom inquiries about the preliminary application <br />should be directed: <br />NAME <br />ADDRESS <br />CITY ZIP COUNTY <br />PHONE AREA CODE ( 1 - <br />NAME TITLE <br />ADDRESS <br />CITY ZIP <br />PHONE <br />AREA CODE ( 1 <br />P •ct description: label project segments (A, B, C, ... ) on table below and mat). <br />Project Segment <br />Length of <br />segment <br />Width of <br />segment <br />Surface <br />- material <br />Extent of site preparation . <br />Cost <br />On <br />road <br />On road <br />w/barrier <br />Off <br />road <br />D Location of bikeway project: Attach county and/or municipal map showing: <br />• project location in community • scale of map • public access to proposed project • present bikeway system • adjacent land use <br />• identify bike safety problem areas <br />E] Project justification: Refer to reverse side of white copy for further explanation. <br />Safety: <br />Service Area: - - - <br />Land Use: - <br />Planning: - - <br />I <br />_v <br />What endorsement has this proposed project received? (i.e., city board, bike club.... 1 <br />Source of local share funding <br />