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1 • Cont'd from pg 2 . Application Evaluation Review Sheet Applicant Name : App # 336 , Bames Groves , 4ac., Address : P . O . Box 846 , Vero Beach , FL 32961 Tract Number(s) : Field Number(s) : Bames #37 Date : Nov . 6 , 2003 VI. Review Summa : Land Use/Field : Acres : Micro-Irrigated Citrus Grove 55 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 , 520. 001 $ 5 , 640 1 25 225 . 60 $ 1 , 880 . 00 VII. Remarks : VIFk DesignateO QqAservationist: F*" // / lb /p03 (Signature) r Date: 1 (Checked By) Date: v lei IR/SWCD Board Approval Date (Applicant Signature) 40F 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 fumish 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 )