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FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION <br /> DIVISION OF LAW ENFORCEMENT <br /> SPECIAL WATERWAY PROJECTS PROGRAM <br /> APPLICATION FORM <br /> APPLICANT INFORMATION. <br /> 1. Name of Applicant: Indian River County <br /> 2. Federal Employment Identification Number: 5 9-6 0 0 0 6 7 4 <br /> 3. Project Manager: Terry B. Thompson—P.E. <br /> 4. Title: Capital Projects Manager <br /> 5. Address:1840 25th Street, Vero Beach, Florida 32960 <br /> 6. Telephone:(5 61)_567-8000 Fax: 778-9391 Suncom: 224-1282 <br /> FINANCIAL INFORMATION. <br /> 1. Total cost of proposed project.$ 8 0,0 0 0.0 0 <br /> 2. Grant funds requested. $ 80.000.00 <br /> 3. Local funds available. <br /> a. Cash $ <br /> b. In-kind $ <br /> c. Other $ <br /> SUPPORTING DOCUMENTATION. <br /> Submit the following items with your original application along with 3 application photocopies. Please note that <br /> your application is incomplete and will not be processed until these items have been received: <br /> _ X 1. Resolution authorizing that a designated representative has authority to apply for and administer the <br /> grant on behalf of the applicant. <br /> X 2. Boundary map of the project area. The map must provide a description and sketch of the project area <br /> boundaries,displaying known easements,and be legally sufficient to identify the project area. <br /> X 3. Color,on-site photographs sufficient to depict the physical characteristics of the project area. Aerial <br /> photographs are also requested. Please mark approximate boundaries of the project site. <br /> X 4. An 8.5 x 11 photocopy(project site vicinity only)of a current NOAA North American Datum 83 <br /> nautical than(provide the NOAA chart name and number)indicating the precise location of the project site. <br /> NOAA charts may be obtained from: Distribution Branch(N/CG33),NOAA-National Ocean Service,6501 <br /> Lafayette Avenue, Riverdale,Maryland 20737.1199,(301)436-6990. <br /> __I_5. Latitude and longitude coordinates(indicating degrees,minutes,and seconds). <br /> X 6. Site control documentation(e.g.deed,lease, results of title search,etc.)for the project site. <br /> 1 7. Photocopies of necessary project permit(s)or permit application(s). <br />