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.4.PP'LICANT SIGI\TA'�"LJRES <br />The landowner's signahire indicates their agreement to: <br />.. Grant the RCD's and GLWM s� epresentative(s} access to the parcel where the conservation practice will be located. <br />(�iomeowner initiaUdate ' ���;,�.�'���� ) <br />t"� r <br />2. Obtain all permits required in conjunction with the installation and establishnlent of the practice prior to starting <br />construction of the practice. <br />3. Be responsible for the aperation and maintenance of conservation practices applied under this prograrn in accordance <br />Gvith an operation and maintenance plan pregared by the RCD's technical representative. <br />4. Cost-share funds fi-om the GLWMO ��ill not exceed 50 percent of the total material cost ta establish the conservation <br />practice. <br />�� � �����L'-�`���' ����:£�'t � Social Security or Tax ID number fi�r reimbursesnent <br />�"`��,�:„� � , �"��*'�������,., �� �;e `�"��.� - <br />�d � �`"':, <br />"� � �� � � w�__`� ������.�?� ,��� ,�f°`a� �""�' �,�`✓ ��;� i�� �,�: � � ��� � {� ""!."°1 C�° c°� `,� I <br />Q�'�i�' U� ��.Y W} <br />+CONSEi�UA�TiON PRAC'I'ICE <br />.. <br />The conservation practice category for w�iich cast-share is requested is, _�=��f� �:+i7 �7,,� <br />`` <br />The estimated practice cost is .$�I �`�-�. <br />TECHNICAL ASSESSiVIEN'I' Al�tI} CC?ST E5'i'I1VIA'Y'E <br />�iave reviewed the site where the above listed conservation practice(s} are to be installed and find that they are needed and <br />,�nat tl�e estirriated ��;�tities and c.osts are �����ical and reasonatile. <br />' RCD Technical yi��1'i:aet77ufa3�� ,.p,�^„':,` i?ate <br />�."°�,�' �,�,�,� �,..�.�"` <br />� . <br />�; �,� �""'��;�.� r�� _ ��., _ � �` <br />F �� :�� ,�, . X�N <br />��: �, .. _ <br />�` �, _ , ` <br />�.� � �..'�"� � <br />� <br />ANlE��1?+"�' AUT�I+DItIZEi? F(3R COST-SI�AIiE <br />Cost-sharing not to exceed $ �t`�. �!� on the basis of `f3 percent of the cost estimate. <br />:_ <br />! KCD Administrative.'Board Ftepresentatioc t;5;�;� <br />-�,,.^�.,�..fi..,..�.,e,.,_„ <br />?ICATI�N aF PRACTICE INSTALLA'I'IU` "'"°'�"' <br />,.�,�fiy��- � , <br />���� <br /><�,'�OUNT AIJ`I'Ht)�tIZED F�la PAXlY�E'.�1T' <br />��� <br />The amount authorized for payment is $, ��� t' <br />RC'DAdministrative/f3oard Renresentative � <br />`� 31 jan08 <br />