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Cont'd from pg 2 . b � ` .B ` � xhl Application Evaluation Review Sheet Applicant Name : App. #405 , Shinn Groves Address : P . O . Box 690342 , Vero Beach , FL 32969 Tract Number(s ) : Field Number(s) : 11 Date : I July 9 , 2004 VI. Review Summary: Land Use/Field : Acres : Micro-Irrigated Citrus Grove 40 Best Management Practices Applied For: 1 . On4ite Water Detention/Retention . Total BMP Costs: 7096 Cost Share: Div By Total Eval Points: = Applicant's Score: Applicant Cost: $327307 $22 ,615 100 226 . 15 $99692 VII . Remarks: VIII . pesignated C nse tionist: 775;2/z2 �l l�i /z) Isignatu ) I Date: (Checked By) Date: L 7 �r3 —4n IRSWC9 Board Approval Date , tAp'plicant Signature) 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 )