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STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION <br /> STATE MATCHING GRANT FOR FAA AIRPORT IMPROVEMENT PROGRAM - APPLICATION <br /> DOA-0012 (REV 0612011) <br /> PLEASE PRINT OR TYPE AND COMPLETE ALL ITEMS <br /> PART 1. AIRPORT INFORMATION <br /> PUBLBC ENTITY AIRPORT NAME PERMIT NO <br /> City of Redlands Redlands Municipal Airport SBD-032 <br /> CONTACT NAME TITLE <br /> Will Hamilton Airport Supervisor <br /> BUSINESS ADDRESS BUSINESS PHONE <br /> 35 Capon Street, Suite 222,Redlands,CA 92373 (909)798-7655 <br /> PART 11 PROJECT INFORMATION <br /> Verify that project is within the Department's most recent Capltal Improvement Plan ® YES ❑ NO If no then project is not eligible for grant funds <br /> DES CR{PTIVE TITLE OF APPLICANT'S PROJECT(as shown en page one of the executed grant agreement and in the FEDERAL <br /> adopted Capital Improvement Plan) GRANT <br /> Attach Additional Sheets If Necessary $150,00000 <br /> Construction of the Redlands Airport Light and Sign Plan,Phase 1I1.This final phase will include APPLICANT <br /> the PAPI, RE1LS ,distance remaining signs wind cones, segmented circle,and airport beacon FUNDS <br /> s9,167 00 <br /> STATE <br /> FUNDS s7,50000 <br /> TOTAL COST <br /> OF PROJECT s166,66700 <br /> Maximum is 5%of the federal crani amount <br /> PART III REQUIRED SUPPORTING DOCUMENTS <br /> Pursuant to Public Utilities Code Sections 21681-21684 and Section 4067 of the CAAP Regulations please submit the following documents with this <br /> application <br /> • Local government approval(resolution or minute order)as described in Section 4067(a) <br /> FAA Grant Agreement with FAA and sponsor signatures <br /> Verification of full compliance with the California Environmental Quality Act(CEQA)by submitting information to fulfill either 1.or 2 below <br /> 1 Copy of Notice of Exemption or provide the Categorical Exemption Class# 15302(c) (CEQA Guidelines Sections 15300 15333) <br /> 2 Copy of Notice of Determination or provide the following Information <br /> Environmental Impact Report(Title/Date) State Clearinghouse(SCH)# or <br /> Negative Declaration(Title/Date) State Clearinghouse(SCH)# or <br /> National Environmental Policy Act(NEPA)document(Title/Date) <br /> (NEPA documents-Environmental Impact Statement or Finding of No Significant Impact must comply with CEQA provisions) <br /> • 11 x 17 inch Drawing or Airport Layout Plan showing project location(s)and dimensions <br /> Completed CAAP Certification(Form DOA 0007),if not submitted to the Division of Aeronautics earlier for this fiscal year <br /> Additional documentation may be required If Items in the FAA AIP grant are not eligible for CAAP funding <br /> PART IV. AUTHORIZATION <br /> AU OFFICI SI TLE TITLE <br /> Mayor <br /> PRINT NAME DATE <br /> Paul W Foster /o/ 7 <br /> SEND COMPLETED APPLICA I�ANDUPPORTING DOCUMENTS TO. tATTEST: ��c.,�YCALIFORNIA DEPARTMENT OF TRANSPORTATION <br /> 3ne Donaldson, City Clerk DIVISION OF AERONAUTICS MS#40 <br /> P O BOX 942874 <br /> SACRAMENTO,CA 94274-0001 <br /> ADA Notice For individuals with sensory disabilities this document is available in alternate formats For information call(916)654-6410 or TDD (916)654-3880 or <br /> write Records and Forms Management 1120 N Street,MS-89 Sacramento CA 55814 <br />