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<br />A. Name of Applicant: <br /> <br />B. Federal Employer Identification Number: <br /> <br />C. Population: <br /> <br />D. Current Operating Budget: <br />(This is the operating budget <br /> <br />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 <br />this grant if 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. <br /> <br />I hereby certify that the information provided in this application is true and accurate. I further <br />.. .'-----certifythat IpossesstheauthoritytoappiyJor this grant on behalfofthe' applicant: (Attach a <br />letter or resolution giving authorization to apply for this grant) <br /> <br />Signature of Authorized Representative <br /> <br />Date <br /> <br />2. PROJECT INFORMATION <br /> <br />A. Name of Project: <br /> <br />B. Project Type (Check One): Project cannot be a combination of acquisition and <br />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 <br />minimum of25 years) by the close ofthe submission period (September 13,2002). School <br />board property is ineligible. State owned property must include a letter from Department of <br />Environmental Protection's Division of State Lands approving application on development. <br />Include a copy ofthe site control documents (e.g., deed, lease, etc.). <br />(please Tab as Exhibit "N") <br /> <br />C. PROJECT LOCATION: <br />