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Name of Applicant: c try CupAy <br /> Date Received: I/23/20{3 <br /> Grant Request: S 3S;ocao <br /> HB 04-1365: (Plans) Evaluation Checklist <br /> Applicant Demonstrates: Yes No Comments: <br /> That it is a covered entity <br /> If answered "no"to the above question, then is it an entity which will sz2 M ArVG. <br /> soon become a covered entity? PST y Ns <br /> (Only answer this question if the applicant is NOT currently a 5sq AF <br /> "covered" entity) Did they provide a reasonable engineering estimate <br /> of future annual retail demand for the next 3-5 yrs. , all based on I ,-F <br /> population projections, building permits, expected new taps, and or <br /> some other creditable information that would show that the entity will <br /> become a"covered"entity <br /> Disclosure of organizational structure/chart <br /> APPt,Jots A <br /> Current retail water demand for each of the past five years (in acre ft. / r 3 <br /> or million gallons) <br /> A written statement from the entity's governing board, stating the AP(e-rJoix F <br /> entity's commitment to the"plan" and the implementation of long-term <br /> water savings measures and programs (w/authorized signature) c` y R UT Or-1 <br /> Apptic t1oo Requirements: <br /> Cover letter with the entities: name, contact information, and a <br /> signature of an individual with the authority to commit the resources of <br /> the entity <br /> A list of people and/or organizations that will be involved in assisting <br /> with putting the plan together(list of who will be utilizing the grant \/ PG 2 <br /> money) <br /> Not required,but preferred, Information characterizing past water use GA\16. % kk00w',' <br /> by sector, (e.g. residential, commercial, industrial) and the source (e.g. ✓ 2 <br /> surface water, groundwater, etc). <br /> Characterization of the water system: <br /> Current(and if available past)per capita water use for the last five / -FA 61...E 4 <br /> years and the basis for this calculation Sit-lG 4y <br /> Past, current, and predicted future population served by the entity, (and / <br /> the source of this information) �/ <br /> List estimated water savings goals to be achieved through the rt, 4 - <br /> implementation of the"Plan", based on water system, the past <br /> conservation efforts and the future water needs <br /> Adequacy, Stability, and reliability of the entity's water system <br /> *to be measured and examined by staff through analysis <br /> Paragraph stating the purpose and the primary features of the entity's <br /> desire to create a water conservation plan <br /> A detailed narrative (description) of tasks to be performed with grant APk,_gcix C - <br /> monies (related to the water conservation plan, and water efficiency AFC a ' uPo" <br /> measures) *(a"scope of work" can combine this item with the timeline )Ai-cc 1=4:x <br /> described below) <br />