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<br />Please identify the state, <br />regional, or local <br />governmental entity that is <br />an eligible recipient of the <br />funds. <br /> <br />Please identify the specific <br />. segment or activity for which <br />project funding is requested. <br /> <br />NOTE: According to the T & I <br />Committee, the request must finance <br />at least 80 percent of the total <br />estimated cost of the specific segment <br />or activiry fry either (1) the amount <br />requested fry the Member; or (2) the <br />amount requested fry the Member <br />and other specificallY designated <br />Federal, state, local, or private <br />funding sources. <br /> <br />Highways <br />_ MN Departinent of Transportation <br /> <br />Public Transit <br /> <br />_ MN Departinent of Transportation <br /> <br />_ Local Government (only one entity may be selected) <br /> <br />_ Metropolitan Planning Organization "MPO" <br />(write in name and address) <br /> <br />_ Transit Agency (write in name and address) <br /> <br />_ City (write in name and address) <br /> <br />_ County (write in name and address) <br /> <br />_ Other (write in name and address) <br /> <br />Rail <br /> <br />_ Amtrak <br />_ MN Departinent of Transportation <br /> <br />Activity choices (you may select more than 1 activity) <br /> <br />_ Construct <br />_ Plan <br />_ Design <br />_ Engineer <br />_ Conduct environmental review <br />_ Acquire right-of-way <br />_ Conduct alternatives analysis <br />_ Research <br />_ Develop <br />_ Demonstrate <br />_ Deploy <br />Reconstruct <br />Rehabilitate <br />Replace <br /> <br />5 <br /> <br />-119- <br />