facility grant application - oregon · web viewoppo sition describe the steps taken to notify...

Boating Facility Grant Application FormTo Acquire, Improve, and Renovate Public Recreational Boating Access

Oregon State Marine Board

FOR OSMB USE ONLY Boating Facility Grant number:Biennium: 2017-19 Date received:

Instructions regarding this application and the Boating Facility Grant program can be found in the Boating Facilities Grant Procedure Guide

I. APPLICANT INFORMATIONApplicant or entity name:

Telephone number:

Cell phone:

Applicant mailing address:

City:

State Zip code:

Name and title of the project manager:

E-Mail:

Office phone number:

2. PROJECT INFORMATIONProject type: Acquisition Construction Consultant design/engineering

Master planning Consultant permitting/environmental/cultural

Project name: Is the need for this project identified in the Marine Board’s Statewide Boating Access Improvement Plan “Six-Year Plan”? Yes No If yes, indicate the priority ranking: Low Medium High

Are you requesting assistance from OMB staff for: Waterway Permitting (USACE, DSL, DEQ) Yes No

Engineering (Survey & Design) Yes No

3. SITE LOCATION AND OWNERSHIP INFORMATIONPark or facility site name: Waterbody: River mile:

Site location: County: GPS coordinates (Decimal): Latitude: Longitude: Tax map # Tax lot # Driving directions – How would a boater find this facility from a major highway or interstate?

U.S. Congressional District Number: Oregon Legislative District Numbers: House: Senate:

Identify the current ownership of the site:

Site is owned in fee simple by the applicant. How long has the applicant owned the site? yrs.

Describe any restrictive easements or deed restrictions: Site is leased by applicant. Number of years remaining in lease:

Name of property owner: Describe other interest in site and tenure: Identify the applicant’s current management of the site:

Site is managed solely by the applicant. Site is managed cooperatively with another entity

Identify the entity (volunteer host, concession, etc.):

Grant Application Revised 2018

4. GENERAL SITE INFORMATIONExisting site features/amenities not related to recreational boating

Day use area Marina/Moorage Trails

Campground Designated swim area Dog parks

Picnic Area Commercial Boating Onsite business’ or rentals

Other

Site maintenance:Identify who maintains the site and facilities? Applicant Other (specify):

5. SITE USEIdentify all of the entrance, parking, day-use, and any boating-related use fees charged at this site:Day-use $ Launch $ Parking $ Short-term dock: $ per (foot, day)

Other fees (describe and list the amounts):

Estimate the current mix of boats that use this facility (based on 100%):

<16 ft. motorized % 17-26 ft. motorized % 27 ft. and over % All non-motorized %

Identify the types of boats currently using this site (by percent):Fishing boats % General pleasure boat %

Sail boats % Ski boats %

Cruiser/yachts % Personal watercraft %

Kayak/canoe % Other paddle craft %

Estimate the amount of use at this facility:Number of launch/retrievals per year:

Number of boats mooring overnight per year:

Identify the months that boating activities take place using a scale of High (H), Medium (M) and Low (L) for the amount of use occurring in the month. If no activity leave blank .

MonthBoating Activities

Fishing Watersports Cruising Sailing Paddling OtherJanuary February March April May June July August September October November December Please identify Other Boating Activity


Identify any other public or private boating facilities(ramps, tie-up facilities or marinas) within a 5-mile radius on the same waterbody:

Name of facility: Direction (N,S, E,W) Distance (Miles) 1. 2. 3. 4. 5. 6.

6. PROJECT NARRATIVE DESCRIPTION

Answer all parts completely (the spaces expand, if you need more space use a separate piece of paper). This is your opportunity to “sell” your project. Do not assume Marine Board staff will know this information.

A. Describe the need for the project (i.e.; what is the problem or issue; how long have problems existed; what measures have been taken to address problems; how will the project resolve problems or issues; etc.).

B. Describe the specific actions, materials or equipment the Applicant or Others will be matching to this project (i.e.; administration oversite, inspections, force account labor, equipment, volunteer labor, donated materials, or other items not completed by a contractor or consultant). This narrative supports information in Sections 8, 9, and 10.

C. Describe all uses and activities occurring at the site.

D. Briefly describe the history of the site (i.e.; how was it acquired; what was the historic or traditional use of the site).

E. Describe how the project relates to local or regional plans to meet current and future public recreation needs and the needs of the boating public. Identify if the project is included in a Master Plan, Resource Management Plan or other plan.

F. Describe any factors that make this project timely and necessary (i.e.; are facilities in jeopardy of being closed to the public due to unsafe conditions; would matching funds be lost or unavailable if not used; are there other critical conditions or known actions with which this project needs to be coordinated.)

G. Describe how this project may result in a change of current use at the site. (Increase/decrease use, change in types of boat use, increase/decrease in conflict etc.)


7. EXISTING AND PROPOSED PROJECT COMPONENTSCheck all existing amenities at this site. Existing Replace Expand Repair New Consultant

BOAT ACCESS Boat rampBoarding docksShort term tie-up dockGangway

Piles

RESTROOMS Flush restroomVault toilet

Composting toilet

Utilities

PARKING AREA Access roadPaved parking

Gravel parking

Curbs, signs, etc.

VESSEL WASTEDISPOSAL (CVA)

Pumpout stationDump station

Floating restroom

Utilities

MISCELLANEOUS DredgingBreakwater

Ski dockDebris deflection boom

Other (specify)

PROPERTYACQUISITION

Attach completedAppendix A


8. PROPOSED PROJECT FUNDING – ADMINISTRATIVE MATCH Not eligible for Grant Reimbursement

Applicant Other Marine Board TOTAL

Administration $ $ N/A $

Federal indirect rate (complete table below) $ $ N/A $

Pre-agreement expenses (complete table below) $ $ N/A $

Permit fees $ $ N/A $

Legal fees $ $ N/A $

System development charge (SDC) $ $ N/A $

Other (specify) $ $ N/A $

Total Administrative Match $ $ N/A $

Federal Indirect RateFederal Approved

Indirect Rate What is it applicable to? Total Value How much is match?

$ $ $ $

Pre-agreement Expenses and Match (include documentation)Item Description Value

$ $ $ $

9. PROPOSED PROJECT FUNDING – FORCE ACCOUNT MATCH

Complete tables below for each. Applicant Other* Marine Board TOTAL

Force account labor $ $ N/A $

Force account materials $ $ N/A $

Force account equipment $ $ N/A $

Total Force Account Match $ $ N/A $

Force Account LaborStaff Other Labor Description Value

$ $ $ $

Force Account Equipment


Owned Donated Equipment Description and Purpose Value $ $ $ $

Force Account Materials or SuppliesOwned Donated Material or Supply Description and Purpose Value

$ $ $ $

10. PROPOSED PROJECT FUNDING – CASH MATCHApplicant Other Marine Board TOTAL

Property acquisition cost $ $ $ $

Construction contract $ $ $ $

Materials Purchased $ $ $ $

Equipment Rental $ $ $ $

Eligible permit fees $ $ $ $

Federal indirect rate*-(complete table below) $ $ $ $

Consultant contract(attach copy of contract) $ $ $ $

Other: $ $ $ $

Total Cash Match $ $ $ $

Federal Indirect RateFederal Approved

Indirect Rate What is it applicable to? Total Value How much is match?

$ $ $ $

*Reimbursement is only eligible on projects that have federal funds from Clean Vessel Act (CVA), Boating Infrastructure Grant (BIG) or Sport Fish Restoration Funds (SFR).

11. TOTAL PROPOSED PROJECT FUNDINGApplicant Other Marine Board TOTAL

Total Administrative Match (from 8) $ $ N/A $

Total Force Account Match (from 9) $ $ N/A $

Total Cash Match (from 10) $ $ $ $

GRAND TOTAL $ $ $ $

12. “OTHER” SOURCE, TYPE AND AMOUNT OF (NON-APPLICANT) CONTRIBUTIONSGrant/Loan Agency Name of Grant/Loan Approved- Y/N Amount of Grant


$ $ $ $

Cash Contributions by Amount of Contribution $ $ $ $

13. PERFORMANCEDescribe your performance on any grant(s) previously awarded by the Board. Are you in compliance with applicable rules, policies and guidelines? This includes, Boating Facility Grants, Small Grants and the Maintenance Assistance Program Grants.

14. PUBLIC INPUT, COMMENT, NOTICE AND PUBLIC SUPPORT / OPPOSITION

Describe the steps taken to notify neighbors, adjacent land owners, site users, etc. of the proposed project. (Please attach supporting documents.)

Describe what opportunities have been provided to involve the public in decisions resulting in this proposed project. (Please attach supporting documents.)

Identify specific public support and opposition to the proposed project:Note: this section is part of the grant ranking criteria-include emails and letters with application

Supporters Name Opponents Name Adjacent land owners: Users groups: Neighborhood association Local government: State/federal government: Legislator/congressional: General Public Other (specify):

15. CUTURAL AND ENVIRONMENTAL Yes No UnknownCultural Resources: If question 1 is YES and question 2 is No then fill out Appendix B Cultural Resources Form

1. Are there any historic, archaeological, or cultural sites or resources on the site?

2. Has a cultural resources survey or report been completed for the project site?

3. Have you consulted with Tribal Governments regarding this project?


Attach documentation of consultation.4. If so, identify specific Tribal Government(s) and contact person(s).

Tribal Government Name Phone

a.

b.

c.

d.

e.

5. Have you consulted with State Historic Preservation Office?Attach documentation of consultation.

Fish and Wildlife Resources Yes No

Have you consulted the local Oregon Department of Fish & Wildlife (ODFW)?

Name of ODFW Local biologist: Phone Number:

Are there any protected upland species or habitat on this site? If Yes, answer the following questions. If No go to next section.

1. Identify any listed species and where the proposed work will be in relationship to the species and any impacts:

2. Describe how the project may impact the protected plan or animal species including changes to their habitat. Identify the mitigation measures that will be used to reduce adverse effects on the species and their habitat:


Wetland Water Resources Yes No Unknown

1. Will any work be done in wetlands on this site? If No go to Water Resources

2. Has the wetland delineation or mitigation plan been completed? If No complete Appendix C Part 1

Water Resources1. Structures in federally navigable waterways may require a Section 10 Permit from

the Army Corps of Engineers (ACOE). See Corps Guidance

2. Public boat ramps and docks in state navigable waterways may require a Facility license from Oregon Department of State Lane (DSL) See DSL Guidance

Will the project require any work to be done below the high water mark? If No, go to next section.

1. Pending Applications:

If DSL and ACOE have not issued permits, have both applications been submitted and accepted? If Yes, provide application numbers and filing datesACOE Permit Number: ACOE Acceptance date:

DSL Permit Number: DSL Acceptance date:

2. Issued Permits:Have DSL and ACOE permit application for the project been issued?If Yes, provide permit numbers and dates. ACOE Permit Number: ACOE Approval date:

DSL Permit Number: DSL Approval date:

3. No Permit Applications Filed:If DSL and ACOE permit applications have not been filed, who will prepare them? Complete Appendix C Part 2

Applicant Consultant OSMB to assist Applicant


http://www.oregon.gov/dsl/WW/Pages/Permits.aspx

http://www.nwp.usace.army.mil/Missions/Regulatory/FAQ.aspx

16. CITY/COUNTY PLANNING DEPARTMENT AFFIDAVIT Note: construction projects onlyTHIS SECTION TO BE COMPLETED BY LOCAL AUTHORITY HAVING JURISDICTION

This information is needed to determine if the proposed project complies with statewide planning goals and is compatible with local comprehensive plans (ORS 192.180). Not applicable to federal agency applicants.

YES NO N/A (FEDERAL)Is the project subject to a local comprehensive plan and zoning ordinance?Have land uses been approved?(Please include documentation of final approval)Is the project compatible with the local comprehensive plan & zoning

ordinances?(Please cite appropriate plan policies, ordinance section, and case numbers).

Policy/Ordinance/Case Number Compatibility of this project with the local planning ordinance cannot be determined until the following local approvals are obtained:

Conditional use permit Development permit Plan amendment Zone change

Other

An application has has not been made for the local approvals checked above.

Planning comments:

*Signature of local planning official:

Title: Date:

*Must be authorized signature from your local City/County Planning Department.

This space intentionally left blank.


17. RACIAL AND ETHNIC IMPACT STATEMENT

T hi s for m i s us ed for i nformati onal pur pos es only and mus t be i ncl uded w ith the gr ant appl ic ati on.

Chapter 600 of the 2013 Oregon Laws require applicants to include with each grant application a racial and ethnic impact statement. The statement provides information as to the disproportionate or unique impact the proposed policies or programs may have on minority persons1 in the State of Oregon if the grant is awarded to a corporation or other legal entity other than natural persons.

1. The proposed grant project policies or programs could have a disproportionate or unique p o siti v e impact on the following minority persons:

Indicate all that apply:

Women Persons with Disabilities African-Americans Hispanics Asians or Pacific Islanders American Indians Alaskan Natives

2. The proposed grant project policies or programs could have a disproportionate or unique n e g ati v e impact on the following minority persons:

Indicate all that apply:

Women Persons with Disabilities African-Americans Hispanics Asians or Pacific Islanders American Indians Alaskan Natives

3. The proposed grant project policies or programs w ill h a v e n o disproportionate or unique impact on minority persons. Yes No

If you checked numbers 1 or 2 above, on a separate sheet of paper, provide the rationale for the existence of policies or programs having a disproportionate or unique impact on minority persons in this state. Further provide evidence of consultation with representative(s) of the affected minority persons.

I HEREBY CERTIFY on this day of , 20 , the information contained on this form and any attachment is complete and accurate to the best of my knowledge.

SignaturePrinted Name: Title:

1 “Minority persons” are defined in SB 463 (2013 Regular Session) as women, persons with disabilities (as defined in ORS 174.107), African-Americans, Hispanics, Asians or Pacific Islanders, American Indians and Alaskan Natives.


18. APPLICATION SIGNATURE AND CERTIFICATIONApplicant Signature and CertificationApplication is hereby made for the activities described above, together with attachments. I certify that I am familiar with the information contained in the application and, to the best of my knowledge and belief, this information is true, complete, and accurate. I further certify that I possess the authority, including the necessary requisite property interests, to undertake the proposed activities.

I also certify that the Applicant’s governing body is aware of this request and has authorized the person identified as the official representative of the Applicant to act in connection with this application and subsequent project as well as to provide additional information as may be required.

By signing below, I affirm the Applicant’s intention to enter into a Cooperative Facility Grant Agreement and agree to comply with Oregon State Marine Board’s program rules, policies, and guidelines as well as all applicable federal, state, and local laws relating to this proposal, additional conditions applicable to an approved Boating Facilities Grant, and the resulting project.

Print/Type Name Title

_______________________________________ Applicant Signature Date

18. ATTACHMENTS (Are the following items attached to this application?)Required For: Acquisition Consulting Construction

Cover letter

Existing condition and photographs of boaters using facilities

Location/vicinity map (Assessor’s map)

Design/engineering or conceptual plans & engineers estimate

Letter(s) of support or opposition, including e-mails (printed)

Documentation of opportunities for public input/comment

Copies of permit applications or approved permits, if available

Consultant contract, if applicable

Tribal Governments proof of consultation documentation

SHPO consultation documentation or cultural resource reports

Pre-Agreement Documentation, if applicable

Federal Indirect Rate Documentation, if applicable

Property acquisition form, Appendix A

Cultural resources form, Appendix B

Wetland Water Resources form, Appendix C

Note: Instruction regarding this application and the facility grant program can be found in the Boating Facilities Grant Procedure Guide, or you may contact the Boating Facilities Manager, Oregon State Marine Board, 435 Commercial St. N.E. #400, PO Box 14145, Salem, Oregon 97309, Phone: (503) 378-2628.


http://www.oregon.gov/OSMB/library/docs/Facility_Grant_Procedure_Guide_narrative_1315.pdf

http://www.oregon.gov/OSMB/library/docs/Facility_Grant_Procedure_Guide_narrative_1315.pdf

Appendix AProperty Acquisition Form

Please answer the following to the best of your ability.

Appraisal completed: Yes No Date of Appraisal: Type of appraisal:

Appraised value of property: $ Assessed value: $ Acreage:

Current ownership: Private Public Agency Other (Specify)

Willing seller: Yes No Name of Seller (unless confidential):

Acquisition Method: Purchase Eminent Domain Transfer Condemnation Donation

Current Zoning: Will property need to be rezoned? Yes No

1. Describe what is located on the site and how the site is currently being used:

2. Is the applicant prepared to initiate within two years from the purchase, design, permitting and construction of boating improvements Yes No If NO answer the following questions:

a. Reasons for immediate acquisition of property.

b. Facilities to be developed and timeline for development.

c. Non-boating uses to be continued on the property and the projected date when non-recreation use will be terminated. If non-boating use on the property is not terminated within three years from date of acquisition, then conversion requirements may apply. A determination that a conversion of use has taken place can only be made by the Board.

d. Type of public recreation access to be provided during the interim period.

e. Demonstration that income derived during the interim period will be used on the project site.

3. Attach supporting documentation.


Appendix BCultural Resources Form


1. YES, there are known historic, archaeological or cultural sites or resources at this site.

a. Describe how the proposed work may affect these resources and identify proposed measures to mitigate any impacts (NOTE: Do not divulge the location of archaeological sites or objects here. Archaeological site information is exempt from the public records disclosures and must be kept confidential pursuant to both federal and state laws.)

b. Describe the natural condition prior to modifications or settlement:

c. Describe the land-use history, when it was first settled or modified, and the depth of ground disturbance or fill:

d. Describe the current land use and condition. Identify any natural agents (e.g., sedimentation, vegetation, inundation) or cultural agents (e.g., cultivation) that might affect the ability to discover cultural resources:

e. Explain whether you or anybody else knows of cultural resources in or near the project area:

2. Provide a copy of the cultural resources survey or report that was completed for this project site.


Appendix CWetland Water Resources Form


Part 1: Wetland Water Resources

1. Describe the type and condition of wetlands present. Are they tidal or fresh, disturbed or not, permanent or seasonal, etc.?

2. Describe the type of work to be done and the size and extent of the area affected:

3. Describe where the proposed work will be in relationship to any wetlands and any impacts on wetland resources:

4. Describe the location, type, and amount of compensatory mitigation work to be done to offset the effects of the proposed work on wetlands, tidal waters, and non-wetland waters: See DSL Guidance *

5. Attach wetland delineation and /or mapping if completed.

Part 2: Water Resources 1. Identify any fish or aquatic species federally listed as threatened or endangered:

2. List any consultations, biological opinions (provide copy), ESA Section exemptions, or other ESA related activities that may apply to this project:

3. Describe how the project may impact the migration, spawning, rearing, or habitat of affected salmon, eulachon, or sturgeon species and the mitigation measures that will be used to reduce adverse effects on protected species and their habitat:

4. Describe how the project may impact the migration, feeding, or habitat of other threatened or endangered species and the mitigation measures that will be used to reduce adverse effects on the species and their habitat:


http://www.oregon.gov/dsl/WW/Pages/Permits.aspx

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