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Cont'd from pg 2 . Application Evaluation Review Sheet Applicant Name : App . #1 , Whiteface Acres Address : 4150 11 Place S . W. Vero Beach , FI . 32978 Tract Number(s) , Field Number(s) : Date : 12/2/02 Land Use/Field : Acres : Micro-Irrigated Citrus Grove 79 Best Management Practices Applied For: 1 . Installation of Micro4rregation System , Laj..4 49 - 0 j$ 29r625 Total BMP Costs: o Cost Share: Div By Total Eval Points: = Applicant's Score: Applicant Cost: $137868 79 175 . 54 ll. Aelf!`italls` . i ,. . . This cost - share afire ent has been co - funded by the USDA - NRCS ,4nP program , according to guidelines in the Citrus B Handbootc . FDACS funds evera e with that ro ram to s read cost - hare u ds further . �! O 2 O Z Signature) batJ (Checked By) Date: r IRSWC [d Approval Date Applicant Signature) Date Privacy Act Statement: The following statements are made in accordance with the Privacy Act of 1974 (5U . S .C . 522a) . The authorities for requesting the information to be applied on this form are: 16 U .S.C. 59Oa-f (Soil and Water Conversation); 16U .S . C. 3801 et seq. (Food Security Acto of 1985, as ammended), and the regulation promulgated theruder. The information requested is necessary for the evaluation of an application , development and implementation of a conservation plan as the basis for satisfying program eligibility and compliance requirements, and for providing technical education, or financial assist- ance under the previously mentioned authorities. Furnishing this information is voluntary; however, failure to furnish correct, complete information will result in the withholding or withdrawal of such technical , educational, or financial assistance. This information may be furnished to other USDA agencies, the Internal Revenue Service, the Department of Justice, or the other State or Federal law enforcement a encies, or in response to orders of a court, magistrate, or administrative tribunal. IRSWCD Page 3 (10-26-01 )