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Name of Applicant: e-Rte <br /> Date Received: i/t3 /'i+ <br /> Grant Request: IP"v4)0%1 <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 <br /> soon become a covered entity? <br /> (Only answer this question if the applicant is NOT currently a <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 <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 /> Cover letter with the entities: name, contact information , and a <br /> signature of an individual with the authority to commit the resources of N./ <br /> the entity <br /> A written statement from the entity's governing board, stating the <br /> entity's commitment to the"plan" and the implementation of long-term <br /> water savings measures and programs (w/authorized signature) <br /> Disclosure of organizational structure/chart ✓ AT Acs+frut.. A <br /> Current retail water demand(metered water use) for each of the past ✓ Pte, 3 _ 66, 3 r 2 <br /> five years (in acre ft. or million gallons) <br /> A list of people and/or organizations that will be involved in assisting R...1 <br /> with putting the plan together(list of who will be utilizing the grant <br /> money) <br /> Not required,but preferred, Information characterizing past water use p '2,- 4 <br /> by sector, (e.g. residential, commercial, industrial) and the source (e.g. <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 ✓ �. <br /> years and the basis for this calculation °°� 20 '1- <br /> Past, current, and predicted future population served by the entity, (and ✓ PG. - 7- <br /> the source of this information) <br /> List estimated water savings goals to be achieved through the (t L - s°ta <br /> implementation of the"Plan",based on water system,the past ° hd�ya "''Y E. <br /> conservation efforts and the future water needs sky 'x's <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 <br /> monies (related to the water conservation plan, and water efficiency Tr ` "^E OT ' <br /> measures) *(a"scope of work"can combine this item with the timeline <br /> described below) <br />