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Rice Creek Watershed District <br />StormwaterManagementGrantProgram <br />2025 Application Form <br />I.APPLICANTINFORMATION <br />DjuzpgDfoufswjmmf <br />Organization (to be named as Grantee): <br />2991NbjoTusffu <br />Street Address: <br />Dfoufswjmmf-NO66149 <br />City, State, Zip: <br />Fyfnqu <br />Tax Status: Tax ID#: <br />ΛĻ͵ŭ͵Ͳ ƌƚĭğƌ ŭƚǝĻƩƓƒĻƓƷͲ ƓƚƓΏƦƩƚŅźƷ ЎЉЊΛĭΜΛЌΜͲ ƦƩźǝğƷĻ ĬǒƭźƓĻƭƭͲ ĻƷĭ͵Μ <br />II.PROJECTCONTACTS <br />NbslTubu{CsvdfEfKpoh <br />Project Officer:Financial Officer: <br />DjuzBenjo0FohjoffsGjobodfEjsfdups <br />Title:Title: <br />762.8:3.8:42762.8:3.8:43 <br />Telephone:Telephone: <br />Fax:Fax: <br />ntubu{Adfoufswjmmfno/dpncefkpohAdfoufswjmmfno/dpn <br />Email:Email: <br />III.PROJECTINFORMATION <br />DfoufswjmmfDjuzIbmmTupsnxbufsSfvtf <br />Project Name: <br />2991NbjoTusffu <br />Location(s) of Project: <br />DfoufswjmmfNOBoplb <br />City:State: County: <br />702036:02036 <br />Project Start Date:Project Completion Date: <br />Project Type (check only those that directly apply): <br />WaterQualityTreatment ProjectStormwaterReuse IrrigationProject <br />5 <br />PeakRunoffRateControlProject RunoffVolumeControl/ FloodStorageProject <br />Other: <br />IsaRCWDRuleCpermitrequiredforthisproject?YES NO UNKNOWN <br />5 <br />IV.GRANTREQUEST <br />36-111 <br />RCWD Grant Funding Requested: $ <br />36-111 <br />Applicant Match Funding Committed:$ <br />1o0b <br />State/Other Funding Committed: $Source(s): <br />61-111 <br />Total Estimated Project Cost:$ <br />Would you be willing to accept grant funding in an amount less than requested?YES NO <br />5 <br />V.SIGNATUREOFAPPLICANT <br />Icertifythattheinformation containedwithinthisapplicationistrueandaccurate. <br />23022035 <br />SignatureofProjectOfficerDate <br /> <br />