Tacma Pwer Water Access Grant 2019 Due date: March 22, 2019 APPLICATION FORM PACKET Includes: 1. Checklist 2. Instructins fr applicatin 3. Applicatin frms 1
APPLICATION FORMS CHECKLIST All applicants are required t submit Applicatin Frm 1 (Main Applicatin), including: General Infrmatin (page 1) Prject Descriptin (page 2) Funding Request (page 3) Landwner Infrmatin and Authrizatin (page 4) Signature Page (page 5,make cpies as needed fr additinal signatures) All applicants are required t submit maps and drawings, including: Maps: Three minimum, can be n same page Drawings f the prpsed prject imprvements All applicants are encuraged t answer supplemental questins in Applicatin Frm 2: Supplemental Questins. Questins may be answered within the Prject Descriptin n page 2 r n attached blank pages. All applicants may submit phts. Phts can be f similar structures r f the lcatin. Phts must be labeled. Aerial phts f the lcatin are encuraged. Nn-prfit rganizatins are required t add Applicatin Frm 3: Nn-Prfit Organizatin, including: A cpy f the IRS letter granting nn-prfit status A cpy f the nn-prfit s Missin Statement r similar dcument A list f the bard f directrs Cperative Prject are required t add Applicatin Frm 4: Cperative Prjects: If yu have mre than three rganizatins, make cpies f the blank frm. Include each rganizatin s signed cpy f the Signature Page. 1
INSTRUCTIONS FOR APPLICATION FORMS Please read all applicatin materials and the Infrmatin fr Applicants t insure the prpsed prject meets all criteria befre submissin. Obtain and submit an applicatin Obtain an applicatin r get answers t questins frm Cindy Swanberg, Tacma Pwer by: Email request t cswanber@cityftacma.rg Dwnlad the Infrmatin fr Applicants and Applicatin Frm Packet at: MyTPU.rg/Cwlitz Phne at: 253.502.8362 In writing t: Cindy Swanberg, Natural Resurces, Tacma Pwer, 3628 S. 35 th St., Tacma, WA 98409-3192 Keep a cpy f yur applicatin fr yur recrds Fill ut the fillable frm and save it t yur cmputer. Yu may als print it and fill it ut by hand. Submit applicatins by mail r e-mail t: DUE DATE March 22, 2019 Applicatin frmatting Cindy Swanberg, Natural Resurces Tacma Pwer 3628 S. 35 th St Tacma, WA 98409-3192 cswanber@cityftacma.rg Type r print clearly in black ink. Supplemental pages shuld have 1-inch margins. The frms can be hand-written. The fnt shuld be at least 11 pint s it is readable. Maps r phts shuld nt exceed 11 x 17 inches. Drawings sent via e-mail shuld be in.pdf r jpg frmat. Which applicatin materials are needed? An applicatin will cnsist f several applicatin frms depending n the type f applicant. Refer t the infrmatin belw and the checklist t determine which are necessary. A cmplete applicatin als requires maps and drawings and may include ptinal phts and supplemental infrmatin. 2
INSTRUCTIONS cnt. APPLICATION FORM 1 MAIN APPLICATION (Required fr all applicants, 5 pages) General Infrmatin (page 1) The Prject Name shuld cntain the lcatin in the name i.e. Cwlitz River Trail at xxx Park. Lead Organizatin name and Cntact persn: Put the full name f the rganizatin r agency and a cntact persn authrized t submit an applicatin and cmmunicate with Tacma Pwer. If this is a Cperative Prject with tw r mre applicants, check the Cperative Prject bx and als fill ut Applicatin Frm 4: Cperative Prject identifying the ther rganizatins. A Lead Organizatin needs t be delegated fr purpses f cmmunicatin. Prject Descriptin (page 2): The Prject Descriptin is an verview f the prpsed prject. If yu chse nt t answer the questins n Applicatin Frm 2: Supplemental Questins yu shuld attempt t discuss them in this sectin. The text shuld be n lnger than ne page. It shuld include: A brief summary f the bjectives and expected results f the prject, Where it is lcated, What yur rganizatin prpses t d with the funding, Hw peple will benefit frm the cmpleted prject, Hw it cmplements ther nearby recreatinal pprtunities, Any partnerships r cmmunity supprt, and Whether the prject will require match funding and if s, when it is expected and what alternatives are available if match funding is nt btained. Funding Request (page 3) A funding request requires the applicant t ask fr a specific amunt f mney frm Tacma Pwer and t describe brad cst cmpnents such as planning, materials, labr csts, administratin, etc. If ther funding is being used t cmplement Tacma Pwer funding it must als be described. If Tacma Pwer funding is identified as the match fr anther grant, any additinal bligatins assciated with the secnd grant must be acceptable t Tacma Pwer. Cst cmpnents shuld be fr the prtin requested frm Tacma Pwer, but shuld als bradly identify the parts t be funded by the ther surces s evaluatrs can determine the scpe f the prject. Nte that if yu receive the grant, Tacma Pwer payments are reimbursements fr eligible paid expenditures. 3
Landwner Permissin (page 4) If the prject is prpsed n lands wned by smene ther than the applicant s rganizatin, then the Landwner Infrmatin and Authrizatin sectin n Page 4 is required. Initial cnsent is demnstrated by the landwner s signature indicating that the prpsed prject, if funded, can be cnstructed n their prperty. In additin, the landwner acknwledges by their signature, that if the prject is funded they will wrk with the applicant t craft a Cperative Agreement that describes maintenance respnsibilities and liability in the future. Signature Page(s) (page 5) An authrized representative frm the applicant s rganizatin must sign and date the applicatin. Fr Cperative Prjects each f the applicants must sign. Additinal signature pages can be cpied, signed and attached. The signature page can be submitted by email by the deadline but the riginal signature page(s) shuld be mailed at the same time. APPLICATION FORM 2: SUPPLEMENTAL QUESTIONS (page 6) All applicants shuld cnsider filling ut this frm, but it is ptinal. The Funding Cmmittee will be able t evaluate the prject mre cmpletely if yu prvide shrt answers t the supplemental questins. Answers can be submitted as part f the Applicatin Frm Prject Descriptin n page 2 f the Applicatin Frm Packet r n a separate page(s) as lng as the Prject name and Lead Organizatin name are n each page and the supplemental questin number is included. APPLICATION FORM 3: NON-PROFIT ORGANIZATION (page 7) Only nn-prfit grups need t fill ut this frm. Nn-prfit rganizatins must als prvide prf f their current IRS nnprfit status, the Missin Statement (r equivalent), and a list f their current bard f directrs. A cpy f a reslutin supprting the applicatin is encuraged, but is nt required unless the prject is chsen fr funding. APPLICATION FORM 4: COOPERATIVE PROJECTS (page 8) This frm is nly needed fr prjects with tw r mre applicants. Use the same lead rganizatin that is shwn n the General Infrmatin frm n page 1 f the Applicatin Frm 1: Main Applicatin. If yu have mre than three cperatrs, make cpies f the blank frm. MAPS (add pages as needed) Several maps are required and must prvide the fllwing infrmatin: 4
A reginal map shwing the lcatin f the prject in relatinship t ther areas in the Cwlitz River basin. This map shuld shw majr rads, water bdies and twns. A site lcatin map shuld shw the prject lcatin and surrunding areas in a radius f abut ne mile in enugh detail t allw a user t find the lcatin f the prject. This map shuld identify the prject in relatin t the prperty bundary, any imprtant neighbring prperty wners, rivers, streams, lakes r wetlands, and any private r unimprved rads necessary t access the prject. A useful surce is the Lewis Cunty WebMap available at the Lewis Cunty website under Map Library (GIS) https://gis.lewiscuntywa.gv/webmap/ The lcatin f prpsed imprvements n the prperty must be drawn t apprximate scale and labeled s that evaluatrs can find the apprximate cnstructin site n the grund. This can be dne n an aerial pht such as Ggle Earth, the Lewis Cunty Web Maps aerial phts r hand-drawn r n a hand-drawn map. This map des nt have t be a legal survey, but shuld shw apprximate prperty lines. DRAWINGS Preliminary drawings are required fr cnstructin prjects. These drawings can be drawn by hand r cmputer. Final drawings are required fr cnstructin prjects that are funded, but these are nt required at the time f applicatin. All drawings shuld have sufficient detail t evaluate the feasibility f the prject and identify any ptential impacts. They must include: A plan view (frm the tp) f any structures t be built. Fr trails r rads, a map is sufficient shwing the trail rute. Side views f structures t be built. Fr trails r rads, a typical crss sectin is sufficient. Any wrk requiring grund-disturbing n Tacma Pwer prperty shuld be identified and the depth f disturbance estimated. All drawings shuld be drawn t scale and dimensins shwn, including elevatins abve grade r water surface. Any wrk in r abve the water shuld label the rdinary high water line f the water bdy. PHOTOS AND OTHER GRAPHICS Phts are nt required, but are encuraged t shw the site lcatin bth frm the grund, and if available, in an aerial pht. Aerial phts are available fr mst parcels frm the Lewis Cunty Web site and frm Ggle Earth. The phts must be labeled. If the pht is f a similar structure installed elsewhere it shuld be nted n the pht. Other types f drawings r cnceptual graphics can be submitted 5
Water Access Grant APPLICATION FORM 1 MAIN APPLICATION (Required, 5 pages) GENERAL INFORMATION Date Prject name Lead Organizatin name [ ] Is this a cperative Prject? If s, fill ut Applicatin Frm 4: Cperative Prjects Organizatin type (check ne): [ ] City/Twn [ ] Native American tribe [ ] Cunty [ ] Nn-prfit rganizatin [ ] Federal agency [ ] Park district [ ] State agency [ ] Prt district [ ] Public schl district [ ] Public utility Lead Organizatin address City/Twn: State: Zip: Day phne: Email: Cntact Website: persn Cntact persn name: Address if different frm rganizatin: City/Twn: State: Zip: Day phne: Cell phne: Evening phne: Email: 1
PROJECT DESCRIPTION (may attach supprting infrmatin) Prject descriptin: Describe the prpsal. Include bjectives and expected results/benefits f the prject. Additinal infrmatin can include partnerships, supprt, unique features and hw it cmplements ther nearby recreatinal pprtunities. Yu may chse t answer the ptinal supplemental Water Access questins Facilities (Applicatin Grant Frm 2) n this page. Funding Request Ttal prject cst $ 2
FUNDING REQUEST (may make cpies fr cntinuatin) Ttal funding request frm Tacma Pwer: $ Are ther funds r in-kind dnatins being used t cmplete the prject? Yes N Where will ther funding r in-kind dnatins cme frm and when? What is the amunt f ther funding? Cash: $ In-kind value: $ Ttal estimated prject cst: $ Describe cst cmpnents n the table belw such as permits, planning, cnstructin, equipment csts, cntracting, vegetatin restratin, administratin, mileage, inspectin, dcumentatin, surveying, etc. Include nly csts requested frm Tacma Pwer. Item descriptin fr Tacma Pwer funding Cst Prject cmpnents frm utside funding r in-kind dnatins 3
LANDOWNER INFORMATION Name f landwner where prject is prpsed: Address: City/twn: State: Zip: Parcel number: Legal descriptin: [ ] Fee title [ ] Easement Is the land pen t the public? [ ] Yes [ ] N Are there public rads t the site? [ ] Yes [ ] N Are there any restrictins n public use and access? [ ] Yes Explain: [ ] N Landwner authrizatin I hereby acknwledge I am the wner r wner s representative f the afrementined land and I supprt the prpsal described herein. I certify the prperty is pen t the public. If this prpsal is funded, I allw the described prject t prceed. I understand any maintenance and liability f funded structures will be described in a Cperative Agreement t be develped. I hereby authrize Tacma Pwer and its agents and cmmittee members t enter nt the prperty fr inspectin prir t any funding decisin. Name(s) (Print): Representing: Signature(s): Date: 4
SIGNATURE PAGE (make cpies if additinal signatures are needed) Tacma Pwer is hereby requested t review and cnsider this applicatin fr grant funding fr the prject described in this applicatin and named belw. This applicatin fllws the guidelines supplied by Tacma Pwer. I/we certify that t the best f my/ur knwledge, the infrmatin herein is true and crrect. Shuld this prpsal be funded, I/we agree t furnish any additinal infrmatin necessary t execute a Prject Agreement upn request by Tacma Pwer. I/we are Tacma aware the Pwer afrementined is hereby requested prject, if t funded, review is and paid cnsider a reimbursement this applicatin basis. fr grant I/we agree funding that fr the any prject additinal described resurces in this required applicatin t cmplete and named the prject belw. herein This applicatin is my/ur respnsibility fllws the guidelines and supplied agree that by the Tacma prject Pwer. will be I/we cmpleted certify as that described. t the best Tacma f my/ur Pwer knwledge, has authrizatin the infrmatin t take herein phts is f true the and prject crrect. and use Shuld them this in any prpsal nn-cmmercial be funded, I/we fashin. agree By t signing furnish this any dcument additinal the infrmatin applicant agrees necessary that decisins t execute by a Tacma Prject Agreement Pwer, including, upn request but nt by limited Tacma t its Pwer. cmpliance I/we are aware with the the requirements afrementined f this prject, prgram, if funded, are slely is paid at the n a discretin reimbursement f Tacma basis. Pwer, I/we agree and a that any decisin additinal cncerning resurces the cntent required f t an cmplete applicatin the and prject the herein granting is r my/ur denial respnsibility f a grant is and deemed agree cnclusive. that the prject will be cmpleted as described. Tacma Pwer has authrizatin t take phts f the prject and use them in any nn-cmmercial fashin. By signing this dcument the Organizatin applicant agrees name: that decisins by Tacma Pwer, including, but nt limited t its cmpliance with the requirements f this prgram, are slely at the discretin f Tacma Pwer, and a Address: decisin cncerning the cntent f an applicatin and the granting r denial f a grant is deemed cnclusive. Organizatin City/Twn: name: State: Zip: Address: City/Twn: State: Zip: Authrized Representative Name (Print): Title Authrized Representative Signature: Date: Name (Print): Title Signature: Date: 5
Water Access Grant Date APPLICATION FORM 2 SUPPLEMENTAL QUESTIONS (Optinal) (Please answer n a separate sheet f paper r n the Prject Descriptin page) Prject name Lead Organizatin name 1. Have yu btained a grant frm Tacma Pwer in the past fr the same area? 2. Hw many recreatinal users in a year d yu anticipate will benefit frm the prject? 3. Describe the type f user yu expect, where they cme frm and hw they use the prject. 4. Has this prject been dcumented in any planning dcuments? If s, please prvide references r cpies f the pertinent parts. 5. Describe why this prject is unique and hw it meets a recreatinal need. 6. Hw des this prject fit in with ther recreatinal pprtunities in the area? 7. Is this prpsal part f a larger develpment plan? If s, please describe. 8. Will this prject be ADA accessible? Please describe. 9. Will yu charge a user fee t the public fr use f the prject? If s, hw much? 10. What, if any, special envirnmental and permitting cncerns will yu need t cnsider? 11. Describe hw yu will insure the prject gets dne n time and within budget. 12. Can yu cmplete this prject frm start f funding t cmpletin in tw years? 13. Have yu ever applied fr funding fr this prject frm ther surces? If s, please describe the utcme. 14. Will yu need t btain additinal funding fr the prject? If s, hw will yu btain it and what is yur timeline? 15. Describe any ther similar prjects yu have undertaken and their current status. 16. Hw will yu ensure maintenance cntinues fr at least 25 years? 6
Water Access Grant APPLICATION FORM 3 NON-PROFIT ORGANIZATIONS (Only fill ut fr nn-prfit rganizatins) Date Prject name Lead Organizatin name Enter the name f the rganizatin as shwn n IRS dcuments. Attach a cpy f the Internal Revenue Service letter granting nn-prfit status as a 501 (c) (3) r a 501 (c) (4) rganizatin. Attach a cpy f the Missin Statement r equivalent. Prvide a list f current bard f directrs. Sme f an rganizatin s members must be active in Lewis Cunty r Cwlitz Cunty, Washingtn. Name f rganizatin as shwn n IRS letter: Is the IRS letter attached? [ ] Yes [ ] N Is the list f the current bard f directrs attached? [ ] Yes [ ] N Is the missin statement r equivalent attached? [ ] Yes [ ] N Is the missin related primarily t natural/cultural resurces, [ ] Yes [ ] N turism r utdr recreatin? If nt, describe hw the prject fits the rganizatin. Des yur rganizatin have members in Lewis r [ ] Yes [ ] N Cwlitz cunties? 7
Water Access Grant APPLICATION FORM 4 COOPERATIVE PROJECTS (Only fill ut fr cperative prjects with tw r mre applicants) Date Prject name Lead Organizatin name Secnd Organizatin cntact Name: City/Twn: State: Zip: Day phne: Email: Secnd Organizatin type (check ne) [ ] City/twn [ ] Native American tribe [ ] Cunty [ ] Nn-prfit rganizatin [ ] Federal agency [ ] Park district [ ] State agency [ ] Prt district [ ] Public schl district [ ] Public utility Third Organizatin cntact Name: City/Twn: State: Zip: Day phne: Email: Third Organizatin type (check ne) [ ] City/twn [ ] Native American tribe [ ] Cunty [ ] Nn-prfit rganizatin [ ] Federal agency [ ] Park district [ ] State agency [ ] Prt district [ ] Public schl district [ ] Public utility 8
SUPPLEMENTAL INFORMATION
SUPPLEMENTAL INFORMATION