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<br /> ost- , 55lstance ~ Icatlon. '-e:reement, aD am aIm <br /> Da.. Landowner SCD Contract, Page 6 or 6 <br />IN ACCOUNT WIm THE 0312001 Delta Canal Company <br />DELTASCD Soc. See. or Tax IdeaL No. Address <br /> 84-1245391 477 1600 Road, Delta. Colorado 81416 <br /> <br />COLOR;' <br />C S <br /> <br />') RIVER BASIN SALINITY CONTROL r <br />A . A I' A dP <br /> <br />.GRAM <br />CI' <br /> <br />I (we) the undenigncd. do hereby request cost-mare lWduncc to help defray the cost ofuutalhns the wi! and water conservallOtl pracUCct as lISted below. It IS lUldentood and agreed that: <br />1. Befon r<<el\'lnlan)' cost-sbare fund.. It will be a.cesaaryfor the laadown.r(s) 10 sip Ih. .aneDllal below relatlol to the molDteaance of practices Inslalled. <br />2. Pradlces must be pl.nned aod IDsbll~ III accordaDc' "Uh techniC'lllI spectncatlobS ollhe Natural Resou~ Conservation ~",Ice (NRCS). <br />3. The responslblelKboldaa musl mike prior detennlDalloo thai the p...ctlces.... feaslbl. oa the site wb.n Ihe)' are to be IDstalled, that tbey are properl)' pianned <br />and Installed, aDd thai uUmatll of quantities are proper .nd realGDable, <br />-'. It.... 01 cost for wbich reimbursement Is later claimed ....10 be luppol1td b)' dowDleatatioa of pa)'DItDU made or dUll to contndo" or olhtr workers. <br />5. This applicotioD will Dot be efl'edt\'l uDtll.pprond by tII. Soli Coosef"Ylltlon District (SeD), Claims for pa)'ID.ot will not be .ccepled more IhaD ohl' (9) montbs <br />from .Ite date tbis a"UcaUoD is .pprond. DDIeu,.. esleasloa Is pDIed by the SCD. <br />6. ltbnmaDl rehnbtanemeDt will be limited to the perceDt al"flltapoD. Dot 10.XC'ftd 70% 01 the adual cost 10 Ibe landowner; tbe percentage of a,.trage costs <br />spedried belo,,; or, tb. amouDt oblipled by tbe SCD. whichever II thelealt. <br /> <br />LOCATION OF PRACTICE:.E..m, SEC 25.30, TWP 15 S, RNG, R96W. R95W. DELTA COUNTY <br />FORUM 2000 FUNDS CONTRACT # 2??oo05 <br /> <br /> APPLICANT'S REQUEST PRACTICE UNITS PERFORMED <br /> AVG MAXIMUM COST. <br /> COSTI ASSISTANCE SHARE RATE SHARE: <br /> EXTENT X <br />YEAR PRACTICE UNIT EXTENT UNIT % $ YEAR EXTENT AVG _% SMALLEST <br /> ACT RATE <br />2003 428A NON <br />CINn REINFORCED <br /> 6 CONCRETE <br /> DTCH & CNL <br /> LINING <br /> 6A Cncrete Dtch. 2" Fool 830 10,70 70 6,216,70 <br /> ( I'Bouom) - 36" <br /> 68 Concrete Drop Each 8 90,00 70 504,00 <br /> Strua.ures <br /> Contract Expiration Date 12131/05 <br /> If you need more space, please attach a separate sheet. <br />(6,720.70) TOTAL S 92,812,26 TOTAL $ <br />1(:z>..IrA II~"" (I. \,.; ill. .11IfJ -I/.- 2 ~q~""dj LESS OTHER COST -SHARE ASSISTANCE S <br /> Signature of Landowner or Authorized Rep r'rt" 'I Date TOTAL AMOUNT LANDOWNER CLAIM $ <br />f)ractices and Quantities requested are needed and practical and 'Nill LANDOWNER(S) CERTIFICATION AND AGREEMENT: <br />be planned in ac:cordance with NRCS technical specifications. I certify that the items for which payment is claimed were fumished and that the charges <br /> A ~ _A/7 are reasonable. proper, and correct, and no part of the c;laim has been paid, I further <br /> O.1-/Z-o( certify that I am the owner of the above described property and agree that if any or all of <br /> above installed prac:tiaes shall be removed, altered, or modified so as to Jessen their <br />// Signature of Technician Da'e effectiveness 'Nithout consent of the SeD for the "fifespan of the practice(s)" after the <br /> date of receiving payment, that portion of the claimed amount shall be refunded to the <br />.'APPLICATlON APPROVAL: SCD. If title to this lal'lCl is transferred to another party, it shall be my responsibility to <br /> adv\sD tho new 0'NnDl' that this agreement hi in force and to obtain such nO'N CMII'lor'$ <br />The SCD ~rd of ~pervi$O~iPraved thtPPlicant's Request and acceptance of the responsibilities herein. The attached plan/schedule of operations <br />hereby obligate $ 2- . 2.. 2. , prepared by the NRCS is hereby made a part of this agreement. <br /> fM!e,- A,'L. 'J ""/Z -0 J Signalure of Landowner(s) Date <br /> SIMatureo 0 esentative Dat. <br />COMPLETION AND DOCUMENTATION CERTIFICATION: SOil CONSERVATION DISTRICT CERTIFICATION: <br /> I hereby certify that tho above claim has been reviewed by me and I find it . proper claim <br /> against the Delta SCD Salinity Control Cost Share f)rogram fund. <br /> Signature or Technician Date <br /> Authorized Signature Date <br /> Sin nature of seD Represenlative Date <br />Rev. 10199 <br />