Monroe County Stormwater Partnership Program 2020 LOCAL APPLICIATION FOR COST SHARE Page 1

Last Name First Name Date

Address City ST Zip

Email Phone

$ Township What is the name/type of project you are applying for Total Estimated Project Cost

Total Acers If applicable provide your USDA farm information USDA Field #

USDA Tract #

Have you applied for Stormwater Cost Share before? NO YES If yes in what year Is this land enrolled in any Federal/State Programs? NO YES If yes in what program

COST SHARE PROGRAM GUIDELINES • This program is only available to Monroe County residents for land in Monroe County.• This particular program is not available to land that lays inside the City of Bloomington or Town of Ellettsville.• An applicant can only apply for cost-share through this program once every three years.• All payments will be made in arears once the project is completed and verified by a SWCD representative.• If an application is selected for funding the applicant will be required to sign an agreement that will state basic conservation

guidelines and estimated completion date.• All funds are reimbursed at 75% of the total cost of the project up to a maximum of $2000.• Total project cost estimation will be required.• All applications will require a minimum of 4 pictures of the project area/concern, expect for cover crop projects only 1

picture is required.• All application will at a minimum require a small paragraph providing a detailed explanation of how this project will improve

soil health and effect water quality, the more details provided the better.• All application will be considered on a first come, first serve bases, however the following point system will be used to

determine high priority concerns (maximum points available is 9)o 2 point for first time applicanto 2 points if project is located on HEL soil Highly Erodible Land (based on Web Soil Survey soil type)o 2 points if project is within 500 ft of a natural water systemo 2 point if project falls inside a rural housing community in the countyo 1 point if project is a referral from County Stormwater

Please finish your application by complete page 2

Monroe County Stormwater Partnership Program 2020 LOCAL APPLICIATION FOR COST SHARE Page 2

1. Will this project have a direct effect soil health? NO YES If you answered yes to #1 or #2 please explain in detail inyour outcome description below 2. Will this project have a direct impact of water quality? NO YES

Yes, I have included 4 photos of the project area from different angles NO YES If no, please explain why below

Outcome Description (please describe in one or more paragraphs how this project with impact soil health and/or water quality.

By signing below I am acknowledging that I am apply for cost-share funding with Monroe County Soil & Water Conservation District through the Monroe County Stormwater Partnership and that if my application is selected then I will need to sign an agreement entering into a contractual process to proceed with the project. I am aware that Monroe County and Monroe County Soil & Water Conservation District are equal opportunity providers and that all application are considered based on the greatest impact for conservation of our natural resources.

OFFICE USE ONLY

Applicant Signature Board Approval Date:

Applicant Contacted Date:

Left Message

Site Visit Date:

Site Visit Time:

Site Map Printed:

Soil Map Printed:

Please finish your application by complete page 1