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APPLICANT SIGNATURES <br />The landowner's signature indicates their agreement to: <br />1. Grant the RCD's and GLWMO'sl~pre~tative(s) access to the parcel where the conservation practice will be located. <br />(Homeowner in%tiaUdate~~"a ,~ ~!~"C.~~1 ) <br />2. Obtain all permits required in conjunction with the installation and establishment of the practice prior to starting <br />construction of the practice. <br />~. Be responsible far the operation and maintenance of conservation practices applied under this program in accordance <br />with an operation and maintenance plan prepared by the RCD's technical representative. <br />4. Cost-share funds from the GI,WMO will not exceed 50 percent of the total material cost to establish the conservation <br />practice. <br />Dare Landowner Signawre Social Security or Tax ID number for reimbursement <br />OFFICE USE ONLY <br />CONSERVATION PRACTICE <br />The conservation practice category for which cost-share is requested is _ .d>n'kg,.1Dg~ <br />v <br />The estimated practice cost is $ 5" rs8/. ~ <br />TECHNICAL ASSESSMENT AND COST ESTIMATE <br />l have reviewed the site where the above listed conservation practice(s) are to be installed and find that they are needed and <br />that the estimated uantities and costs are tactical and reasonable. <br />RCD Tec~hni/al R~~ ve Date <br />A LINT AUTHORIZED FOR COST-S <br />Cost-sharing not to exceed $ ~~~~ gU on the basis of 10 percent of the cost estimate. <br />Representative I Date <br />CATION OF PRACTICE INSTALLATION <br />RCD Technica~ tat~~ I Date l <br />Z7. YY,O <br />AM®>kPNT AUTHORIZED FOR PAYMENT <br />The amount authorized for payment is $ ~~• <br />RCD Administra jve/Board Representative <br />2 V 3 I jan08 <br />