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Name of Applicant: citePoV-E70 iskent-o PIS <br /> Date Received: 'j/1% / 14- <br /> Grant Request: *-2..' .)G'e'e' ) 2--),moo <br /> HB 04-1365: (Plans) Evaluation Checklist <br /> Applicant Demonstrates: Yes No Comments: <br /> That it is a covered entity / P6, 1 <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 <br /> of 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- / Hoc <br /> term water savings measures and programs (w/authorized signature) <br /> Disclosure of organizational structure/chart ✓ Nor <br /> Current retail water demand (metered water use)for each of the past <br /> five years (in acre ft. or million gallons) <br /> A list of people and/or organizations that will be involved in assisting sGe ,S ,,*e <br /> with putting the plan together (list of who will be utilizing the grant ✓ �, „�_ �,r <br /> money) <br /> Not required, but preferred, Information characterizing past water use M-'--L /'h &�°k.n-JO <br /> by sector, (e.g. residential, commercial, industrial) and the source (e.g. �hYER <br /> surface water, ,roundwater etc). s' `6 <br /> g ) �gwva <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 <br /> Past, current, and predicted future population served by the entity, / icy'. 92 <br /> (and the source of this information) '2"°+o Ce0S0S <br /> List estimated water savings goals to be achieved through the -s°l° - <br /> implementation of the "Plan", based on water system,the past <br /> conservation efforts and the future water needs gs I a� <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 j <br /> desire to create a water conservation plan \/ <br /> A detailed narrative (description) of tasks to be performed with grant <br /> °'E <br /> monies (related to the water conservation plan, and water efficiency <br />