Laserfiche WebLink
APPLICANT SIGNATURES <br />The landowner's signature indicates their agreement to: <br />Grant the RSWCD's representative (s) access to the parcel where the conservation pra e rti r will be located <br />(initial /date ��� <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 />Page 2 of 2 <br />3. Be responsible for the operation and maintenance of conservation practices applied under this program in accordance <br />with an operation and maintenance plan prepared by the RSWCD's technical representative. <br />4. Not accept cost -share funds from RSWCD sources that are in excess of 50 percent of the total cost to establish the <br />conservation practice. <br />Date <br />Landowner <br />Address and Phone Number <br />City /State /Zip Code <br />CONSERVATION PRACTICE <br />The conservation practice category for which cost -share is requested is tohc< ftS'hniAlb✓ — c (cesc 9 0c k- <br />The estimated practice cost is $ <br />-CHNICAL ASSESSMENT AND COST ESTIMATE <br />1 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 quantities and costs are practical and reasonable. <br />RSWCD Technical Representative <br />Date <br />AMOUNT AUTHORIZED FOR COST -SHARE <br />J <br />Cost - sharing not to exceed $ \500 c on the basis of 2Y--- percent of the cost estimate. <br />RS WCD Administrative/Board Representative <br />Board Meeting Date <br />CERTIFICATION OF PRACTICE INSTALLATION <br />RSWCD Technical Representative <br />Date <br />AMOUNT AUTHORIZED FOR PAYMENT <br />The amount authorized for payment is S <br />CD .Administrative /Board Representative <br />Board Meeting. Date <br />4- <br />