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• <br />• <br />• <br />Detailed Bud6et and Schedule: Please describe all sub - activities that are included in the project with the <br />corresponding costs and estimated date of completion; use an additional page if necessary <br />(Example: if the activity is public education you will need to detail how many training sessions, how much will be <br />spent for supplies, how many participants, or brochures, what is the consultant fee, etc.) <br />Sub- activity <br />Amount requested <br />Estimated start date <br />Produce base map including DWSMA, located wells, <br />unlocated wells, watermain, parcels, and aerial images <br />$800 <br />Upon award <br />Analyze data for unused wells <br />$800 <br />Following <br />production of base <br />map <br />Analyze data for undocumented wells <br />$2,800 <br />Analyze data for possible cross connected wells <br />$1,600 <br />Total (amount being requested) <br />$6,000 <br />Certification: I certify that the information herein is true and accurate to the best of my knowledge and I <br />submit this application on behalf of the applicant public water supply system. <br />Signature:. . Title:. . Date:. <br />Note: If you are awarded a grant, NO work should begin until all required <br />signatures have been obtained on the grant agreement, and grantee receives <br />a signed copy of the grant agreement <br />