GENERAL INFORMATION

Project Points of Contact (POC): POCs listed will receive project selection notication from the PDC.

Agency Name:

POC Name:

POC Title:

Address Line 1:

Address Line 2:

E-mail:

Phone #:

Additional Key Project Stakeholders:

Project Terminus Start Project Terminus End

Landmark, Milepost, Cross Roads:

Latitude Coordinates:

(Decimal Degrees to 6 decimals)

Longitude Coordinates:

(Decimal Degrees to 6 decimals)

Page 1 of 8

Project Identification:

Project Title:

Route Name 

and Number:

Federal Land Management Agency (FLMA) Accessed:

a. List all FLMA site(s) and/or major destination(s) that are accessed by the identified transportation facility.

Provide annual visitation for all those FLMA sites and/or major destinations.

b. Identify source(s) for all annual visitation values listed. If using estimated annual visitation (because actual

values are unknown or unavailable), then include the estimating methodology used.

Name of the Federal Land 

Management Agency FLMA Unit Name Site(s) or Major Destination(s) Accessed

Distance from Project 

(miles)

Current Annual 

Visitation

Applying Agency Supporting Federal Land Management Agency (or Agencies)
BACKGROUND DATA

1. Agency with Title to Facility:

2a) Agency with Maintenance Responsibility:

2b) Describe how the maintenance 

responsibility is provisioned. 

Include details for each portion of the 

project (e.g. roadways, parking lots). 

4. Existing Roadway Width

(outside shoulder to shoulder) :

Provide average width in feet 

5. Existing Posted Speed Limit:

Provide in MPH

3. Project Length:

Provide length in miles

6. Existing Bridge Information:

Provide known data for all bridge

structures within the project limits.

Refer to the link for guidance on the 

National Bridge Inventory

National Bridge 

Inventory Structure #

Bridge 

Length (ft.)

Bridge 

Width (ft.)

Bridge 

Area (Sq. Ft)

Bridge 

Suciency 

Rating

7. Functional Classication:

Check those that apply.

National Highway System Arterial Local Road

Major Collector Minor Collector

Refer to the link for guidance on the FHWA Functional Classification System

Current 20-Year 

Projection Data Source / Methodology

Average Daily Trac (ADT)

Seasonal Average Daily Trac

Estimate % of above ADT that

accesses the Federal lands

Page 2 of 8

8. Traffic Volumes:

Provide any available traffic data from

recent counts or other documented

sources.

Note: If no data (i.e., counts) are available,

please estimate range ( < 200, 200 - 500,

500, 500 - 1000, > 1000 vehicles per day)

9. Safety History:

Describe site(s) including the number,

rate and type of crash as well as the user

type(s) that have occurred within the

project limits and the source of this

information (reports or anecdotal). If

available provide site specific crash data

for the last three years.

10. Projects in Proximity:

Describe other current or previously

funded Federal Lands project(s) adjacent

to or in proximity to this project.

Attach available ROW 

documentation and/or 

maintenance agreements.

Attach inspection reports if 

available.
PROPOSED PROJECT

AASHTO State DOT Local Government FLMA

1. Purpose and Need:

Describe the need for the project

including but not limited to who the

project will serve, conditions requiring

relief, and anticipated changes in use due

to the proposed project.

2. Proposed Design Standards:

Project will be designed to the following standards.

Check the standard that best applies to this project.

3. Proposed Roadway (shoulder to shoulder) Width (feet):

Proposed width should be in accordance with the proposed design standards.

14. Proposed Speed Limit:

5. Description of Proposed Work*:

a) Provide a description of all proposed

work including project phase(s) and

major construction work items.

b) Describe how the proposed project will

address the identied purpose and need.

New Construction / 

Reconstruction (4R):

Earthwork/Grading

Road base

Major Drainage ( >48" )

Minor Drainage ( <48" )

Retaining Walls

ROW Acquisition

Utility Relocations

Recycling (3R):

Existing Asphalt / Base Recycling 

(Ex: Pulverization)

Overlay

Milling

Minor Widening ( < 5 ft. )

Major Widening ( > 5 ft.)

Bridge:

New / Replacement

Surfacing:

Asphalt

Concrete

Safety Improvements:

Guardrail

Sight Distance Improvements

Bicycle / Pedestrian:

Bicycle and Pedestrian facility

**Non-Infrastructure:

Planning Study

Planning-Environmental

Linkage (PEL) Study

Research

 Rehabilitation or Repair Roadside Hazard Improvements

**Note: Applications that include non-construction or elements including transit, planning, and/or research, please fill out the 

supplemental worksheet for alternative transportation that can be found on the Wyoming FLAP webpage.

Page 3 of 8

Transit

Bicycle facility (e.g. bike lane)

Intersection / Trac Controls

Parking

Gravel

c) Describe if the project is a segment of a

larger project/route or if this project is/

can be phased. Include any known

alternatives that should be reviewed as

part of this project.

*Note: The Programming Decision Committee has final approval for all proposed project phases and reserves right to reduce scope of work.

16. Key Items of Work: Check all that apply.

1

1

1

1

Provide in MPH
17. Right of Way Acquisition: All Right-of-way (ROW) property (acquisition costs) to be part of the project costs should be detailed in

the project estimate page. All acquisition support costs are not FLAP eligible and will be borne by the applicant.

17a) Is ROW acquisition required?

17c) Describe the anticipated ROW 

acquisition needed to construct the

project. Include the proposed ROW 

width (ft) including formalization of all 

ROW on FLMA lands. 

18b) Will relocation of utilities be required?

19. Environmental Impacts / Resource Protection: Identify and describe known or anticipated impacts, positive or negative,

to biological, cultural, wetlands or water resources, or any other environmental areas.

Describe Anticipated Impacts

Page 4 of 8

18. Utility Impacts: All utility relocation costs must be accounted for by the applicant whether borne by the applicant or

included as project cost. Utility relocation costs should be detailed in the project cost estimate.

18a) List any known utility 

conicts within the project ROW 

and describe any anticipated

utility impacts and proposed 

relocations:

7b). Existing ROW Width (feet): 
21. Public & Stakeholder Involvement: Describe the range of attitudes, both support and opposition, that this proposed project

may receive from organizations, the public and within your own agency. Include coordination efforts and public involvement

efforts completed to date.

Page 5 of 9

20. Proposed Lead Agency: Identify the lead agency that is proposed to lead delivery of this project. It is typical for the CFLHD

to act as the lead agency for duration of the project, from award through project completion. However, If the applicant plans to

have a different agency act as lead for the project, the applicant must provide justification for this position, previous experience in

delivering Federal Aid (Title 23) funded projects and ability to satisfy FHWA project delivery requirements in accordance with the

Wyoming Department of Transportation Projects Manual: 

https://www.dot.state.wy.us/home/engineering_technical_programs/manuals_publications.html 

The final decision for project delivery resides with CFLHD. If delivered by another Agency, FHWA State Division Office and the

State DOT will have Stewardship and Oversight responsibility, where all costs and overruns will be borne by the applicant.

Wyoming Federal Lands Access Program: Proposed Project Acquisition & Impacts
22d) List and provide detail on all non-FLAP funding sources identified above including funding source 

description, restrictions, and timing availability of funds and associated partnerships. If another organization will 

be providing funds, please ensure the organization provides a letter of support for the project.

Page 6 of 9

i. Local, State, or Other Federal Sources (Cash match only) : = % 

2. Utilities

1. Right of Way % 

% 

% 

 = 

 = 

Total Non-FLAP Funds: = 

 = % 

3. Other Contributions = % (at the discretion of the PDC) :

22a) Cost Estimate for Proposed Project (From developed Cost Estimate attached):

22b) FLAP Funds Requested (Up to 100%, no local match is required):

22c) Other Project Funds: If applicable, list any non-FLAP funding source that will be part of the project.

ii. In-Kind Contribution:

22. Cost Estimate: Applicants are required to attach a detailed estimate to support costs referenced below. A sample

Project Cost Estimate is available for use on the Wyoming FLAP webpage. Project cost estimates must include all

project costs including Preliminary Engineering and Construction Engineering costs, Contingency, ROW, utility relocation, 

etc. (Please do not add dollar signs or commas to the cost entries.)

Wyoming Federal Lands Access Program: Proposed Project Funding
23 - Project Fit to Program Vision

A. How does the project align with

the goals of the Federal Lands

Access Program?

B. Describe why the Federal Lands

Access Program is the most

appropriate funding source for the

proposed project as opposed to

other funding sources eligible.

Page 7 of 9

A. What is the proximity of the

project to the federal lands? What is

the significance if access through

the project area was lost or not

provided? Is the facility (project

area) the only access to the federal

lands?

B. Describe how access to these

federal lands will be improved as

result of this project. If applicable,

address improvements to all

transportation modes (vehicular,

pedestrian, bicycle, transit,

emergency, etc.). If applicable,

include how the project will

improve access management (e.g.

reduction in traffic congestion, size/

load limits,etc.).

24 - Federal Lands Access Improvement

*Note: Federal economic generator refers to any use of/on Federal lands that results in economic generation for the local community and/or region.

25 - High Use Recreation Site and Economic Generator

A. Describe how the federal lands,

listed on page 1 of the Proposal

(FLMA Unit(s) Name) are considered

high use recreation site(s) and/or

economic generator(s)* for the local

or regional economy. Explain if/how

the local or regional community is

economically dependent on the

access to the federal land and the

proposed transportation facility.

Wyoming Federal Lands Access Program: Proposed Project Qualifications
A. Describe existing safety

conditions (e.g. below standard

sight distances, roadside hazards,

below standard lane and shoulder

widths, etc.). Describe how the

proposed project will address safety

conditions. For what user groups?

26 - Safety

27 - Preservation

A. Describe the condition of the

facility, including surface condition,

age,pavement condition ratings

(PCI), bridge sufficiency ratings, etc.

Describe how the proposed project

will improve the condition of the

facility, including extending service

life, and impacts to O&M costs.

B. Describe how the facility will be

maintained after construction. Be

specific as to what maintenance

activities would occur, the

frequency, and funding sources.

28 - Natural and Cultural Resources

A. Describe if and how the proposed

project protects and/or enhances

the natural and/or cultural resources

associated with or adjacent to 

federal lands. 

29 - Coordination

A. To what extent have officials

from the applicable FLMA been

involved in identifying and scoping

the proposed project?

B. Describe how the federal lands,

will support or connect to the

improved access explained in 24B.

For example, if building a new

bicycle facility does the FLMA allow

bicycles and where to/from?

Wyoming Federal Lands Access Program: Proposed Project Qualifications

Page 8 of 9
Submittal Instructions: 

1. Save your form as PDF to your computer, with file name similar to: Wyoming FLAP APP

2024<PROJECT NAME>

a. Check that all fields have been completed and that all your work has saved properly

prior to e-mailing your application.

b. Many text fields have been populated with EXAMPLE text, this is to help applicants

understand what kind of information is being asked for. Please delete the EXAMPLE text 

and fill in all applicable fields with original text.

2. Attach all additional files:

a. Review the checklist you completed and attach all photos, maps project estimates, and

forms requiring signatures.

b. Please do not use a zip application to reduce and send large files. The submittal email

address will not accept zipped attachments. To accommodate large attachment sizes,

we encourage sending multiple emails referencing the volume of the email(s) in the

subject line, labeling them '1 of 2,' '2 of 2,' or similar. It is the responsibility of the

sending party to ensure their file has successfully transmitted (not getting stuck in the

e-mail "outbox").

c. ATTENTION: DO NOT USE YOUR PDF SOFTWARE TO ATTACH DOCUMENTS INTO THE

PDF DOCUMENT AS ALL YOUR FORM FIELDS WILL BE INVALID. ALL ATTACHED

PHOTOS, MAPS, SIGNATURE FORMS, AND SUPPORT DOCUMENTS SHOULD BE

SEPARATE FILES.

3. Save a copy for your records

4. E-mail your completed form to cfl.planning@dot.gov, using the subject: Wyoming FLAP APP 

2024 <PROJECT NAME>

5. Check your e-mail's "sent box" to ensure that your file was sent. Larger files may take longer to

send.

a. You should receive confirmation of receipt of your submission within one calendar

week of the call closing date.

Wyoming Federal Lands Access Program: Proposed Project Submittal Instructions

Page 9 of 9