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<br />Is the project included in the <br />Metropolitan Transportation _ <br />Improvement Program <br />(TIP) and/ or State <br />Transportation <br />Improvement Program <br />(STIP)? <br /> <br />Total estimated cost (please <br />write out in numeral form <br />(e.g., $2,000,000, not $2 <br />million) <br /> <br />Request amount (please <br />write out in numeral form <br />(e.g., $1,600,000, not $1.6 <br />million) <br /> <br />What percentage of the total <br />estimated cost is this <br />request? <br /> <br />If you are requesting <br />funding for a specific <br />segment or activity, please <br />describe the overall project <br />of which this <br />segment/ activity is a part <br />and include the total <br />estimated cost. <br /> <br />Is the project included in . <br />MnDoT's Long-Range <br />Transportation Plan? <br /> <br />-120- <br /> <br />_ Retrofit <br />_ Install <br />_ :Mitigate <br />_ Implement <br />Re~lign <br /> <br />Project description (please limit your response to 3-4 <br />sentences; upto 500 characters): <br /> <br />Total estimated cost: <br /> <br />_Yes <br /> <br />Please provide the date of approval of the most recent <br />version of the plan and the tide of the plan. <br />. Date of approval: <br />· Title of the plan: <br /> <br />_No <br /> <br />Yes <br /> <br />Please provide the date of approval of the most recent <br />version of the program ( s), and the title of the <br />program(s): . <br /> <br />_ Metropolitan Transportation Improvement <br />Pro2'ram (TIP) <br />6 <br />