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,Ex f-� � /3 / 7� .� o, Ottd from pg 2 - Application Evaluation Review Sheet Applicant Name : . App. #1 , Whiteface Acres i Address: 14150 11 Place S . W. Vero Beach , Fl . 32978 Tract Number(s ) : Field Number(s): Date : 12/2/021 _ � .. - -- — .. - Land Use/Field: Acres: - Micro4rrigated Citrus Grove 79 Best Management Practices Applied For. I 1 . Installation of Micro4rregation System, Q1 $ 29 , 625 I / Tota18MP Costs: Cost Share: I DIV By Total Eval (Poll • AppMOWS Score•. AppNeWACOaft $13 , 86879 175 .54 . l //►r Yi _ This cost - share afire ent has been co - funded by t e U A - P program , according to guidelines in the Citrus BHandbook . FDACS funds vera e with that oro ram to s read cost - hare u ds further Vill Ste) ate', (Checked 8y) Date: r � IRSWCMAWM t Approval DOM REVIEW 7 (Applicant Signature) / / Oats Privacy Act statorm*.e The following statements are made in accordance with the Privacy Act of 1974 (SU.S.C. 522x). The authorities for requesting the information to be applied on this form are. 16 U.S.C. 590x4 (Sod and Water Conversation); 16U.S . C. 3801 et seq. ( Food Security Acto of 1985, as ammenled), and the regulation promulgated Uvwuder. The information requested is necessary for the evaluation of an application, development and implernentsoon 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, fakwe to furnish correct, complete information will result in the withholding or wlthdrawai of such technical, educational. or financial assistance. This information may be furnished to other USDA agencws, the 1. tLn Revenue Service, the Department of Justice, or the other State or Federal law enforcement agencies, or in response to orders of a court, ma istrate, or administrative tribunai. IRSWCD Page 3 ( 10-26-01 )