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Name of Applicant: Town of Firestone <br /> Date Received: October 1, 2018 <br /> Grant Request: $30,000 <br /> HB 04-1365: Evaluation Checklist (DMP) <br /> Applicant Demonstrates: Yes No Comments: <br /> That it is a covered entity x Avg = 1,979 AF <br /> If the applicant is a covered entity, have they fully complied with x <br /> HB1051 requirements? <br /> Disclosure of organizational structure/chart x <br /> Current retail water demand for each of the past five years (in acre ft. x <br /> or million gallons) <br /> Application Requirements: <br /> Signature of an individual with the authority to commit the resources <br /> of the entity. Include a statement regarding the entity's commitment x <br /> to Drought Planning. Statement of financial need/grant money <br /> requested. <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 x <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. x <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 x <br /> Past, current, and predicted future population served by the entity, <br /> (and the source of this information) x <br /> List of Estimated water savings goals to be achieved. List of drought x <br /> planning objectives to be achieved in this process. <br /> Description of the impacts experienced by the entity, during the 2000- <br /> 2003 or 2012-13 droughts. Include short term and long term impacts, x <br /> as well as social and economic impacts where applicable and as <br /> feasible. <br /> A detailed scope of work to be performed with grant monies x <br /> The "Plans"timeline, stating milestones with dates and end products <br /> with dates; also state the estimated dates when progress reports will x <br /> be submitted to OWCDP staff (25%, 50% & 75% completion) <br /> Detailed budget including consultant/hour fees. List of how the <br /> creation of the "plan" will be funded; list grants, entities funds, and/or x <br /> in-kind services <br /> Does the applicant demonstrate 25% matching funds? In cash, in-kind x 60% match <br />