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Name of Applicant: MT. WE" EP- w £ S DIST: <br /> Date Received: 4/1 I / o2_ <br /> 33)4 x6 <br /> HB 05-1254: Evaluation Checklist for Entities <br /> For Covered Entity Applicant: Yes No Comments: <br /> Is the applicant a covered entity? � 7p! _ 1,400 AF <br /> Does the covered entity have a state approved water conservation plan in / `fmss, /�uG. <br /> accordance with statutory revision 37-60-126? (HB 04-1365)? �/ <br /> (If answered no to the above question)then, Does the covered entity have <br /> a locally adopted water conservation plan with defined water saving <br /> goals? <br /> Did the applicant provide a written statement from the entity's governing <br /> board, stating the entity's commitment to the project and the entity's <br /> commitment to implementing long-term water saving measures and <br /> programs (w/authorized signature)? <br /> Did the applicant provide a cover letter with the entity's: name, contact <br /> information, and a signature of an individual with the authority to commit <br /> the resources of the entity? <br /> Did the applicant provide a list of people and/or organizations that will be PG• 1—2 <br /> involved in assisting with the grant project(list of who will be utilizing <br /> the grant money)? <br /> Characterizing Water System: <br /> Did the entity provide their annual retail water demand for the past five P�,S "n <br /> years (in acre ft. or million gallons)? <br /> Did the entity identify their retail water delivery for each of the past five ✓ 3 2,21 c' <br /> years (in acre feet or million gallons)? <br /> (Not required, but preferred), Did the applicant provide information (t• <br /> characterizing past water use by sector, (e.g. residential, commercial, and <br /> industrial) and the source (e.g. surface water, groundwater, etc). <br /> Did the entity provide current(and if available past)per capita water use ✓ PG.4 - AvU 0.0 M <br /> irs <br /> for the last five years and the basis for this calculation? Sif°a, ° ©jPCd <br /> Did the entity provide their past, current, and predicted future population ✓ — 2cea`lc-0C <br /> ST-A r �. <br /> served by the entity, (and the source of this information)? °k <br /> Did the entity state the water savings that was accomplished in the past 3_ '"'v <br /> five years through water conservation efforts? ✓ <br /> Did the entity state water savings goals to be achieved through the / �• to PnrE .-ti„k� <br /> implementation of the"project"? �/ T° 5` ` M o- <br /> Adequacy, Stability, and reliability of the entity's water system PL -7 <br /> *to be measured and examined by staff through analysis <br /> Description of Proiect: <br /> Did the applicant write a paragraph stating the purpose and the primary <br /> features of the project? ✓ <br /> Did the applicant provide a detailed narrative (description) of tasks to be f. 12-- 1.4 <br /> performed with grant monies (stating how grant money will be used to <br /> achieve project goals)? *(a"scope of work" can combine this item with <br /> the timeline described below) <br /> Did the applicant provide a"project”timeline, stating milestones with <br /> dates and end products with dates; also state the estimated dates when <br /> progress reports will be submitted to OWCDP staff(50% & 75% <br />