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<br />FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION <br />FLORIDA RECREA TION DEVELOPMENT ASSISTANCE PROGRAM <br /> <br />PART I - GENERAL INFORMA TION <br /> <br />(DEP USE ONLY) <br /> <br />RECEIVED: <br /> <br />POSTMARKED.: <br />APPL. NO.: <br /> <br />1. APPLICANT INFORMA TION <br /> <br />A. Name of Applicant: <br /> <br />B. Federal Employer Identification Number: <br /> <br />C. Population: D. Current Operating Budget: <br />(This is the operating budget for the city. county or special district, and not just the department budget) <br /> <br />E. Contact Person: Title: <br />(The contact person is someone who will be in direct contact with DEP and be responsible for administering this grant if <br />awarded) <br /> <br />Address: Street/P.O. Box: <br /> <br />City/State: <br /> <br />Zip Code: <br /> <br />Telephone:( <br /> <br />) <br /> <br />E-mail: <br /> <br />FAX: <br /> <br />If project is not funded, please check here if the grantee wishes to receive application back. 0 <br /> <br />I hereby certify that the information provided in this application is true and accurate. I further certify that I <br />possess the authority to apply for this grant on behalf ofthe applicant. <br /> <br />Signature of Authorized Representative <br /> <br />Date <br /> <br />2. PROJECT INFORMA TION <br /> <br />A. Name of Project: <br /> <br />B. Project Type (Check One): Project cannot be a combination of acquisition and development <br /> <br />Acquisition: <br /> <br />Development: <br /> <br />On land owned by applicant <br />On land currently under site control by applicant <br />Date site control expires: <br /> <br />Trail Construction: On land owned by applicant <br />On land currently under site control by applicant <br />Date site control expires: <br />Development projects must be under site control (owned by deed, or leased or dedicated for minimum <br />of 25 years) by the close of the submission period (October 12, 2001). School board property is <br />ineligible. Include a copy ofthe site control documents (e.g., deed, lease, etc.). (Please Tab as Exhibit "N") <br /> <br />Page 3 of 24 <br /> <br />FPS-A033 <br />