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Name of Applicant:Tot-0,J cF We'c u 1-16 <br /> Date Received: 4/5 / 24218 <br /> Grant Request: %3ot coo <br /> HB 04-1365: Evaluation Checklist for Non-Covered Entities <br /> Applicant Demonstrates: Yes No Comments: <br /> Will the entity soon become a covered entity? <br /> Did they provide a reasonable engineering estimate of future annual <br /> retail demand for the next 3-5 yrs., all based on population Of.y,./r_: z.. r-1 <br /> projections, building permits, expected new taps, and or some other ✓ 3og /ya_ .� <br /> creditable information that would show that the entity would become �y2_ <br /> 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 /> Application Requirements: <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 <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. v/ `PGc; <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, ✓ 'Pc., 1 <br /> (and the source of this information) <br /> List estimated water savings goals to be achieved through the �G g <br /> implementation of the "Plan", based on water system, the past <br /> conservation efforts and the future water needs <br /> Adequacy, Stability, and reliability of the entity's water system ✓ % 9 <br /> Paragraph stating the purpose and the primary features of the entity's <br /> desire to create a water conservation plan / <br /> A detailed Scope of Work of tasks to be performed with grant monies <br /> (related to the plan &water efficiency measures w/ land use planning <br /> requirement) <br /> The "Plans"timeline, stating milestones with dates and end products <br /> with dates; also state the estimated dates when progress reports will <br /> be submitted to CWCB staff (50% & 75%completion) <br />