BCBC Request for Professional Planning assistance BURLINGTON COUNTY BRIDGE COMMISSION 1300 ROUTE 73 NORTH P O BOX 6 PALMYRA NJ 08065-0006 TELEPHONE- 856-829-1900 FAX- 856-829-5205 REQUEST FOR PROFESSIONAL PLANNING ASSISTANCE Contact Information Applicant Name * Applicant Name First First Last Last Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Address Phone * Fax Email * Narrative Section Project Description: * Describe why local funds are unavailable for the project: What is the purpose of the project and what are the project objectives? How will the project be implemented? Describe the steps required to effectuate the project. Provide a time line for implementing the project: Describe the metrics for measuring success of the project: Agreement to Execute Memorandum of Understanding for Project By applying for this Request for Professional Planning Assistance your municipality agrees to enter into a memorandum of understanding (MOU) with the Burlington County Bridge Commission in the event the Commission agrees to provide the requested assistance. The MOU shall set forth: a description of the professional planning services to be provided to the municipality by the Commission; the project purpose and objectives; the municipality’s plan to implement the project and time line for implementation; and a description of he metrics for measuring project success. The Burlington County Bridge Commission shall rely on the MOU and the municipality’s success in implementing the project for consideration of granting future requests for professional planning assistance made by the municipality. Please check the box below if you agree with the terms and conditions listed above * I understand and agree to each and all of the Terms and Conditions in this Burlington County Bridge Commission Request for Professional Planning Assistance Form.Consent for Use of Electronic Signature Agreement. My electronic signature is legally binding. Signature signature keyboard Clear If you are human, leave this field blank. Submit
