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Cont'd from pg 2 . -hB � x � bl � Application Evaluation Review Sheet Applicant Name : App. #305 : Estes Citrus , Inc. Address : 3705 20th St . , Vero Beach , FI . 32960 Tract Number(s) : Field Number(s) : Swan #12 Date . Nov . 6 , 2003 VI . Review Summary: Land Use/Field : Acres : Micro-Irrigated Citrus Grove 40 Best Management Practices Applied For: 2. Install 1 FBR H2o Control Structure. Total BMP Costs: 750/6 Cost Share. Div By Total Eval Points : = Applicant's Score: Applicant Cost: $5 , 624 . 001 $4 , 218 25 168 . 72 $ 1 , 406 . 00 VII . ' Remarks: V II. Designated servationist: IY �/ , d (Signature) Date: (Checked By) ate: IRSWApproval Date ture) Date Privacy Act S 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 . 590a-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 agencies , or in response to orders of a court, magistrate, or administrative tribunal . IRSWCD Page 3 ( 10-26-01 )