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r <br /> Cont'd from pg 2 . b '` l + / <br /> Application Evaluation Review Sheet <br /> Applicant Name : App . #413 ; Hammond Groves, <br /> Address : P . O . Box 3278 , Vero Beach , FL 32964 <br /> Tract Number(s) . <br /> Field Number(s) . Tower <br /> Date . July 9 , 2004 <br /> Land Use/Field : Acres . <br /> Micro4rrigated Citrus Grove 80 <br /> Best Management Practices Applied For: <br /> 1 . On-Site Water Detention/Retention. <br /> Total BMP Costs: 70% Cost Share: Div By Total Eval Points: = Applicant's Score: Applicant Cost: <br /> $41 ,680 $29 , 176 100 291 . 76 $121504 <br /> "I t `,Oft �i a rr ^ <br /> lil• r TV1i , a` itltl. • t Yw1 <br /> (Signature) Dake: (Checked By) Date: <br /> 7-/S _ 0 <br /> C Board Approval Date <br /> 3 <br /> 4(Applicant Signature) Date <br /> Privacy Act Statement: The following statements are made in accordance with the Privacy Act of 1974 (SU . S. C . 522x). <br /> The authorities for requesting the information to be applied on this form are: 16 U .S.C. 590a-f (Soil and Water Conversation); <br /> 16U . S.C . 3801 et seq. (Food Security Acto of 1985, as ammended), and the regulation promulgated theruder. The information <br /> requested is necessary for the evaluation of an application, development and implementation of a conservation plan as the <br /> basis for satisfying program eligibility and compliance requirements, and for providing technical education, or financial assist- <br /> ance under the previously mentioned authorities. Furnishing this information is voluntary; however, failure to furnish correct, <br /> complete information will result in the withholding or withdrawal of such technical, educational , or financial assistance. This <br /> information may be fumished to other USDA agencies, the Internal Revenue Service, the Department of Justice, or the other <br /> State or Federal law enforcement agencies, or in response to orders of a court, magistrate, or administrative tribunal. <br /> IRSWCD <br /> Page 3 (10-26-01 ) <br />