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I�ES <br />� � <br />RE LEAF <br />1999-2001 MINNESOTA ReLEAF <br />COMMUNITYTREE PLANTING PROGRAM <br />APPLICATION FORM <br />- due November 1, 1999 <br />Application is limited to this S-page form - only support letters from cooperators may be attached. <br />Please refer to the Application Guidelines R. Community Tree Planting Program Project Selectic� Guidelines <br />when completing this form. This form is available via email and on disk in various IBM-compatible formats. <br />1. City 8 Project Name Date:-November 1, 1999 <br />City (or County):-Roseville Legal Descript: Tws�:_29_ Range:_23_Sect:_5_ <br />Project Name:-2000 Street Tree Reforestation <br />Is this applicant applying for other Mn ReLeaf funding? _no _ X_ yes - if so, please list other <br />p roj e ct n a m e s h e re : Community Forest Health 8 Community Forest Inventory <br />2. Applicant Contact Information <br />Applicant Organization Name: _Roseville Parks and Recreation <br />Contact Person:-Chuck Stifter Phone No: L651_)415-2115_ <br />Mailing Address:-2800 Arona Street <br />City, State, Zip code: _Roseville, MN 55113 <br />Project Technical Advisor:-Anita Twaroski P h o n e N o: L651_)490-2315 <br />DNR Area Forester:-Larry Westerberq DNR Area: -East Metro Phone No.: -651-772-7929 <br />Make Payment Payable to - Name: _City of Roseville - Parks and Recreation <br />Address: -2800 Arona Street Roseville, MN 55113_ <br />a��t. No.: IG � 3'�tao 0 0 o v3� j37 4 <br />3. Applicant Eligibility (check one) <br />_X-Municipality Township c o u n t y D i�.Scl�o�l i c t <br />Other local government (specify): <br />Non_profit Organization (with 501 (c)(3) status) <br />4. Project Budget Summary <br />a. Non-state cash contributions: $_5500 _30_% of total <br />b. Non-state in-kind contributions: $_5000 _28_% of tatal <br />c. Mn ReLeaf Funding Requested: _75U0���3� _42_% of total <br />TOTAL PROJECT COST (a+b+c): $ 1 ,OUO ����`�'�'�`� <br />5. Property Ownership <br />a. Who is the property owner ?_City of Roseville <br />b. Has property owner permission been obtained? <br />_ X_yes, written _ yes, verbally and written permission will be obtained by <br />no, explain: <br />MnRL Tree Planting Application 1 <br />(date) <br />