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Cont'd from pg 2 . Application Evaluation Review Sheet Applicant Name : App. # 308 : Estes Citrus , Inc. Address : 3705 20th St . , Vero Beach , FL 32960 Tract Number(s ) : 1 Field Number(s ) . Johnston #15 Date : INov . 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: 75% Cost Share: Div By Total Eval Points : = Applicant's Score : Applicant Cost: $7, 371 $5 , 528 25 221 . 13 $ 1 , 843 VII . Remarks : V L Designated servationist: 1 [� /dh%3 (Signature) Date: (Checked By) ate: t IRSWC Bo Approval Date t i ture) 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 . 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 )