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Name of Applicant: CtT"`f flF llel -o <br /> Date Received: 40/36 72o i <br /> Grant Request:S 22� Zoo <br /> HB 04-1365: (Plans) Evaluation Checklist <br /> Applicant Demonstrates: Yes No Comments: <br /> Is the applicant a covered entity? <br /> If answered "no" to the above question,then is it an entity which will A. v Ana. oV P AST <br /> soon become a covered entity? V 4 yp,„ 7,02_ <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 /> If the applicant is a covered entity, have they fully complied with N !A <br /> HB1051 requirements? <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 /> ***0-14441 <br /> A written statement from the entity's governing board, stating the <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 <br /> five years (in acre ft. or million gallons) <br /> A list of people and/or organizations that will be involved in assisting 7 <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 <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, ✓ �. S <br /> (and the source of this information) <br /> List estimated water savings goals to be achieved through the F <br /> implementation of the "Plan", based on water system,the past s fo c>412- iDy,S <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 />