Agenda - Parks and Recreation Commission - 07/14/2011

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4a`r'"E°':7 Minnesota Department of Transportation �1( la K SAFE ROUTES TO SCHOOL 2011 INFRASTRUCTURE GRANT APPLICATION ac rdP� 7. EVALUATION 8. REQUIRED SIGNATURE The school(s) benefiting from the program is(are) required to collect data before and after the SRTS program using the National Center for Safe Routes to School student travel tally and parent survey. Applicants will be disqualified if the school does not participate in the surveys. Please check the box below to indicate your intent. ® Yes, the school(s) understand and agree to conduct the surveys No, the school(s) will not agree to conduct the surveys Signature Applications must be signed and reviewed by an authorized representative of the applicant. By signing this document, the applicant affirms that the statements contained in the application package are true and complete to the best of the applicant's knowledge and assumes responsibility for securing the necessary permits and following all Federal, Mn/DOT, and State Aid design standards. Applicant Signature (required) Name Date Filing Instructions The 2011 SRTS Application Form is a Formatta form and is designed to be completed on your local workstation. The procedure is to download the form and instructions from the Mn/DOT Safe Routes To School website http://www.dot.state.mn.us/saferoutes/index.html and save it to your local system. You will also need a small, free application called 'Filler' that allows you to open and complete the form. Filler is available here: http://www.dot.state.mn.us/stateaid/ formatta/FillerSetupNR.exe. As you download Filler, accept the License Agreement. Accept the Default Destination Location. After the software installs a blank Registration form appears. Ignore this form by clicking the X to close. You will only need to downloaded and installed filler once for each workstation. Please try to be brief and concise when completing the application. Do not include non-relavant information or attachments. When the electronic application is completed please ensure that you have saved it to your local drive or server. Print the application and sign and date on the signature line above. Send the completed electronic application attached to an e-mail to SafeRoutes.DOT@state.mn.us Use the US mail to send 5 copies of the printed application, maps, letters of concurrence, letters of support and other relavant attachments to: Mao Yang Mn/DOT State Aid Division 395 John Ireland Blvd, Mail Stop 500 St. Paul, MN 55155 Electronic and paper copies of the applications are due to Mn/DOT State Aid Division by June 15, 2011 at 4:30 PM CDT. If you have questions about the program or application please submit them to: SafeRoutes.DOT@state.mn.us or call 651-366-3827