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OHIO DEPARTMENT OF NATURAL RESOURCES

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					                                                                                                                      Project Application (09/06)


               Great Miami River Watershed Water Quality Credit Trading Program
                                                     Project Application
1.     SWCD                                                       Resource Management
       Name                                                                  Specialist
       Contact
       Name
2.     Agreement number                                                                         Date
                                     (county-state fiscal year-recipient’s last name)

3.     Check appropriate title of recipient: Owner        or Operator
       Name
       Street address
       City, State, Zip
       Telephone number
       E-mail (if applicable)

4.       Location of practice(s): Include aerial photo or USGS topo map that shows project location and nearest waterbody.
         Address (if different than above):

         Latitude                                                                   Longitude

5.       Name of the nearest waterbody protected by the proposed project:

         11-digit watershed number

6.       Type of operation (please check):         Cropland      ,             Silviculture (Forestry)    ,    Livestock    ,
         Other    (describe)

7.       Is there a Watershed Action Plan for this watershed? Yes     No
         Name of plan:
         Who is the plan sponsor?
         Endorsed? Yes      No         If YES, does this project proposal address an issue identified in the plan? Yes           No

8.       Is there a TMDL for this watershed? Yes         No

9.       What is the status of technical assistance provided to date? (please check all that apply)
         Initial investigation ,       I&E ,         Survey ,       Design ,        Conservation plan
         Self-Assessment

10.      Is there a permanent farmland or conservation easement on the property at the site where the proposed project will be
         installed? Yes    No

11.      Has the recipient previously received cost-share? Yes     No
         If YES, did they meet all the requirements of the previous project agreement? Yes               No   If NO, please explain.


12.      The following questions refer to EQIP-eligibility:
         Has the recipient exceeded their $450,000 Payment Limitation? Yes     No
         Has the recipient exceeded the Adjusted Gross Income provision? Yes     No
         Is the recipient in compliance with the Highly Erodible Land (HEL) and Wetlands Conservation provision? Yes                   No

13.    Potential Ancillary Benefits                                                                           Check all that apply
       Other pollutants reduced
       Bank erosion reduced
       Habitat improved
       Shade increased
       Flow velocity decreased
       Wetlands created
       Floodplains created and/or preserved
       Other

 I certify that this project will comply with all local, state, and federal regulations.
14.     Submitted by:
                                                       (District Administrator or Designee of Board of Supervisors)

 The Miami Conservancy District
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                                                                                                      Project Application (09/06)


Calculate load reductions from proposed practices: (Attach printouts from load reduction software.)
                                         # of Calculated Calculated Cost of         When will the     When will the
                                       acres in Annual Annual Load Practice practice begin?           practice end?
                                        each        Load    Reduction
15. List the name of each Practice
                                       practice Reduction (in pounds)
                                                (in pounds)     TN
                                                     TP




               PRACTICE TOTALS
           TOTAL POUNDS TP + TN
 16. List SWCD Staff activities in relation to installation,                 Hours            X $25           TOTAL
 maintenance, and annual inspection.

                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                                                                                              X $25
                             SWCD STAFF ACTIVITY TOTAL                                        X $25

 17.    BUDGET
                                                                                 PROJECT COSTS
 a      Cost of Practice Total                                    $
 b      SWCD Staff Activity Total                                 $
 c                                       TOTAL PROJECT COST (a+b) $

        FUND REQUEST                                                             PROJECT FUNDS        PERCENTAGE OF
                                                                                                          TOTAL
 d      Trading Program funding requested                                    $
 e      List other fund sources (e.g., landowner contribution, etc.)                 OTHER FUNDS
        1.                                                                   $
        2.                                                                   $
        3.                                                                   $
        4.                                                                   $
        5.                                                                   $
 f                                              TOTAL OTHER FUNDS $
 g                                                  TOTAL FUNDS (d+f) $                                    100%



 The Miami Conservancy District
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posted:10/7/2011
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