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Name of Applicant: Fr,ca.4.d.+s-L0 Euwo 0404selvDtsT <br /> Date Received: to/ / t4 <br /> Grant Request: w)Ito. st <br /> HB 04-1365: (Plans) Evaluation Checklist <br /> Applicant Demonstrates: Yes No Comments: <br /> That it is 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 /> 000000n, r rnts: <br /> A written statement from the entity's governing board, stating the Pct,4-� <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 j <br /> Current retail water demand (metered water use)for each of the past Pq 2. - �" `� <br /> five years (in acre ft. or million gallons) 8,` m kE <br /> A list of people and/or organizations that will be involved in assisting P4 <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 Pti 2 -110,LE I <br /> by sector, (e.g. residential, commercial, industrial) and the source (e.g. ✓ f do,j-eec(o. <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 z - TPc°'`* i <br /> years and the basis for this calculation '°'"``-'' '-" ( <br /> Past, current, and predicted future population served by the entity, Ae <br /> (and the source of this information) ` — '202-4 <br /> List estimated water savings goals to be achieved through the Pti 4 - <br /> implementation of the "Plan", based on water system,the past \/ " "� 1'2. °/0 <br /> conservation efforts and the future water needs <br /> Adequacy, Stability, and reliability of the entity's water system a'j 'F <br /> *to be measured and examined by staff through analysis '7 <br /> Paragraph stating the purpose and the primary features of the entity's t <br /> desire to create a water conservation plan <br /> A detailed description of tasks (Scope of Work) to be performed with pet 1- <br /> grant monies (related to the water conservation plan, and water <br /> efficiency measures) <br /> The "Plans"timeline, stating milestones with dates and end products r rr q.;PAlt» <br /> with dates; also state the estimated dates when progress reports will - '`f n/ <br /> be submitted to CWCB staff (50% & 75%completion) s°% _ j+��c <br /> lrjAL - <br /> List of how the creation of the "plan" will be funded; list grants, \/' krrp.c .T11. C <br /> entities funds, and/or in-kind services <br />