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APPENDIX A Applicant # _ <br /> Form 1 : Application for Cost Share <br /> (Complete a separate application for each grove / block) <br /> Date: <br /> Owner' s Name : <br /> Business Name : <br /> Mailing Address: <br /> Street Address: <br /> Business Phone: <br /> Email Address: <br /> Grove Name : <br /> Block Number: <br /> Acreage: <br /> Check (q) the boxes below to indicate which practices you are requesting cost-share <br /> assistance for this grove / block. <br /> ❑ On-Site Water Retention / Detention <br /> ❑ Conversion or Repair of Flashboard Riser Water Control Structure <br /> ❑ Precision Application Equipment <br /> ❑ Portable Agrichemical Mixing Station <br /> ❑ Chemigation Infrastructure <br /> ❑ Aquatic Weed Barrier <br /> ❑ Permanent Agrichemical ashdown Station <br /> ❑ Water Table Observation Well <br /> ❑ Grade Stabilization Structure <br /> ❑ Conversion to Microirrigation <br /> Application must include a completed copy of the Notice of Intent to Implement. <br /> INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED. <br /> C:Tocuments and Settingslbrendad%My Documents%FDACS lnfolFDACS BMP 20071Water Duality Quantity 10 <br /> Applicants Handbook Rev 12 06.doc <br />