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STATE OF CALfFORNIA - DEPARTMENT OF TRANSPORTATION <br />STATE MATCHING GRANT FOR FAA AIRPORT IMPROVEMENT PROGRAM - APPLICATION <br />DOA-0012 (REV 1212021) <br />PLEASE PRINT OR TYPE AND COMPLETE ALL APPLICABLE ITEMS <br />AIRPORT INFORMATION <br />PUBLIC ENTITY <br />COUNTY <br />City of Redlands <br />San Bernardino <br />AIRPORT NAME <br />PERMIT NUMBER <br />Redlands Municipal Airport <br />CONTACT NAME <br />TITLE <br />Adarian "AJ" Lawson <br />Airport Supervisor <br />MAILING ADDRESS <br />EMAIL <br />PHONE <br />P.O. Box 3005, 35 Cajon St. Suite 222; Redlands, CA 92373 <br />alawson@cityofrodlands.org <br />(909) 557-8520 <br />PROJECT INFORMATION <br />rr0Ject must De in the uepartment s mosi recent uapitai improvemem Tian anc the <br />project cannot commence prior to the State's award of a matching grant or the project ® Check to acknowledge statement <br />becomes ineligible for a matching grant. <br />DESCRIPTIVE TITLE OF APPLICANT'S PROJECT (as shown on page one of the executed federal grant <br />and in the adopted Capital Improvement Plan): <br />Resurface Runway 08126 (4,505' x 75`) <br />This grant will cover the rehabilitation of runway 08126 (PCI 73) and West Apron (PCI 43) to improve the <br />pavement for the same class aircraft. This includes sealing of cracks in the pavement, putting a protective <br />slurry over the entire runway & apron area, and the restriping of runway & apron markings. <br />REQUIRED SUPPORTING DOCUMENTS <br />FEDERAL GRANT NUMBER <br />3-06-0195-023-2024 <br />FEDERAL $ 750,000 <br />GRANT <br />APPLICANT $ 45,833 <br />FUNDS <br />STATE $ 37,500 <br />FUNDS* <br />TOTAL COST 833,333 <br />OF PROJECT <br />*Maximum is 5% of the fedor <br />grant amount. <br />Pursuant to Public Utilities Code Section 21681-21684 and Section 4067 of the CAAP Regulations, 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 # 15301 <br />(CEQA Guidelines Sections 15300-15333). <br />2. Copy of Notice of Determination or provide the following information: <br />o Environmental Impact Report (Title/Date) <br />o Negative Declaration (Title/Date) <br />State Clearinghouse (SCH) # <br />State Clearinghouse (SCH) # <br />o National Environmental Policy Act (NEPA) document (Title/Date) National Environmental Policy Act of 1969 <br />(NEPA documents -Environmental Impact Statement or Finding of No Significant Impact must comply with CEQA provisions). <br />• Airport Layout Plan (ALP) showing project location(s) and dimensions or project sketch if no ALP exists. <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 />AUTHORIZATION <br />AUTHORIZED OFFICIAL'S SIGNATU DATE <br />PRINT NAME TITLE ' <br />Eddie Tejeda Mayor <br />MAILING ADDRESS EMAIL PHONE <br />35 Cajon Street, Suite 222, Redlands, CA 92373 etejeda@cityefredlands.org (909) 798-7531 <br />SEND COMPLETED FORM AND ALL REQUIRED DOCUMENTS TO: <br />AeronauticsGL@dot.ca.gov <br />or <br />or <br />ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms <br />Management Unit at (916) 445-1233, TTY 711, orwrite to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814. <br />