DOT - Special Road Fund Program Application

SPECIAL ROAD FUND PROGRAM APPLICATION
North Dakota Department of Transportation, Local Government
SFN 62528
If you have questions on filling out the application or the program, please contact: specialroadfund@nd.gov
Applicant Type
Name of City, County, State Agency, or Tribal Government
Applicant Contact Information
Name

First NameLast Name
Title
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Roadway Owner (if different)
Roadway Owner Contact Information (Name, Telephone Number, Email)
Engineering Firm Information (If Applicable)
Name

First NameLast Name
Title
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Project Information
Project Name
SRF Category -- Construction & maintenance of access roads to and roads within:
Total Project Cost
Upload Project Estimate (pdf)

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SRF Funds Requested
Source of Local Matching Funds
Project Location
Upload Project Map (pdf)

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Project Length
in Miles
Proposed construction year
Proposed surface type
Speed limit on roadway
miles per hour
Please describe the overall scope of the project
Please describe the need for the project
Is this project on County Major Collector Route?
What is the CMC route number?
Please attach the following documents in PDF format:
- Map showing project location
- Cost estimate (for construction only)
- Other Supporting documents
  - Letters of support
  - Traffic studies
  - Photos
Attach supporting pdf documents here:

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Applicant Signature
Applicant Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Project Information