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e , r <br /> Cont'd from pg 2 . <br /> xhlbi -r 13- <br /> Application Evaluation Review Sheet <br /> Applicant Name . App . # 338 : Graves Bros . Co . <br /> Address : P . O . Box 700-277 , Wabasso , FL 32970 <br /> Tract Number(s) : <br /> Field Number(s) : 76-77 , 77-78 , 70W, 139 40-38 , 21 -53 <br /> Date : Nov. 6 , 2003 <br /> V!. Review Summary: <br /> Land Use/Field : Acres : <br /> Micro-Irrigated Citrus Grove 410 <br /> Best Management Practices Applied For: <br /> 2. Install 6 FBR H2o Control Structure. <br /> Total BMP Costs : 75% Cost Share: Div By Total Eval Points : = Applicant's ScoApplicant Cost: <br /> $ 15 , 836 . 00 re:$ 11 , 877 150 79 . 18 $37959 . 00 <br /> VII . Remarks: <br /> VIII Designated ervationist: <br /> a / /I p I , <br /> (Signature) Date: (Checked By) Date: <br /> WCD Board Approval Date <br /> (Applicant Signature) Date <br /> Privacy Act Statement: The following statements are made in accordance with the Privacy Act of 1974 (5U . S . C . 522a) . <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 furnished 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 />