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Name of Applicant: (Eft FiAtao 1 .14rt Pt sr. <br /> Date Received: 8/Ira /2.0 14 <br /> Grant Request: $ 321 90A• �5Z <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 <br /> of the entity <br /> APP ,; ; nR a i _.: <br /> A written statement from the entity's governing board, stating the PG <br /> entity's commitment to the "plan" and the implementation of long- <br /> term water savings measures and programs (w/authorized signature) <br /> Disclosure of organizational structure/chart ‘/' <br /> Current retail water demand (metered water use)for each of the past RI '- <br /> five years (in acre ft. or million gallons) <br /> A list of people and/or organizations that will be involved in assisting Pct i- 2 <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 , z — cAe, <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 <br /> Past, current, and predicted future population served by the entity, Pq - 2- <br /> (and the source of this information) V/ <br /> List estimated water savings goals to be achieved through the °l° <br /> implementation of the "Plan", based on water system,the past ✓ <br /> conservation efforts and the future water needs `' P"k <br /> Adequacy, Stability, and reliability of the entity's water system ✓ PI 4 <br /> *to be measured and examined by staff through analysis <br /> Paragraph stating the purpose and the primary features of the entity's / Pq <br /> desire to create a water conservation plan �/ <br /> A detailed narrative (description) of tasks to be performed with grant ✓ P `Is <br /> monies (related to the water conservation plan, and water efficiency <br />