Form MO780-1896 "Nonpoint Source Implementation Grant Application" - Missouri

What Is Form MO780-1896?

This is a legal form that was released by the Missouri Department of Natural Resources - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2019;
  • The latest edition provided by the Missouri Department of Natural Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MO780-1896 by clicking the link below or browse more documents and templates provided by the Missouri Department of Natural Resources.

ADVERTISEMENT
ADVERTISEMENT

Download Form MO780-1896 "Nonpoint Source Implementation Grant Application" - Missouri

Download PDF

Fill PDF online

Rate (4.5 / 5) 31 votes
Page background image
FOR OFFICE USE ONLY
MISSOURI DEPARTMENT OF NATURAL RESOURCES
DATE RECEIVED
SOIL & WATER CONSERVATION PROGRAM
NONPOINT SOURCE IMPLEMENTATION GRANT APPLICATION
ALL DOCUMENTATION RECEIVED
Yes
No
1. SPONSORING AGENCY INFORMATION
A. NAME OF SPONSORING AGENCY
B. HAS THE SPONSOR RECEIVED ANY PREVIOUS SECTION 319 GRANTS?
YES
NO
C. SPONSORING AGENCY’S MAILING ADDRESS (STREET, CITY, STATE, ZIP CODE)
D. DOES THE SPONSORING AGENCY HAVE ANY OTHER OPEN 319 GRANTS?
YES
NO
IF YES, PROVIDE THE PROJECT TITLE AND PROJECT NUMBER:
E. SPONSORING AGENCY TYPE (CHECK ONE)
F. SPONSORING AGENCY INFORMATION
EDUCATIONAL INSTITUTION
SPONSOR FEDERAL TAX ID NUMBER:
NONPROFIT 501(C)(3)
DUNS NUMBER:
GOVERNMENT: SPECIFY:
CONGRESSIONAL DISTRICT NUMBERS:
H. PROJECT MANAGER CONTACT INFORMATION (IF DIFFERENT FROM PRIMARY CONTACT)
G. PRIMARY SPONSOR CONTACT (NAME, TITLE, TELEPHONE NUMBER WITH AREA
CODE, FAX NUMBER WITH AREA CODE, E-MAIL ADDRESS)
2. PROJECT INFORMATION SUMMARY
A. NAME OF PROJECT
B. PROJECT START DATE (MM/DD/YYYY)
C. PROJECT END DATE (MM/DD/YYYY)
D. NAME OF WATERSHED PLAN BEING IMPLEMENTED AND THE YEAR IT WAS ACCEPTED BY EPA
E. PROJECT BUDGET SUMMARY
Federal Budget
Section 319 Federal
Nonfederal Match
Other
Categories
Funds Requested
[(40/60) x (319 Funds Requested)]
Match
Salary
See note in application instructions
regarding administrative cap
Fringe
Travel
Equipment (over $5,000)
Supplies
Contractual
Other
Approved Indirect (
%)
$
$
$
Totals
(verify all calculations)
3. SPONSORING AGENCY’S AUTHORIZED SIGNATURE AND APPROVAL OF APPLICATION
To the best of my knowledge, all the information in this application is true and correct. The documentation has been duly authorized by the
governing body of the applicant. As the authorizing representative I attest I have read the required documents and assure I can and will
comply with all requirements and conditions of this grant if awarded.
NAME AND TITLE OF AUTHORIZED ORGANIZATION REPRESENTATIVE
SIGNATURE
TELEPHONE NUMBER WITH AREA CODE
(PRINT OR TYPE)
NAME AND TITLE OF APPLICANT OR PROJECT MANAGER
SIGNATURE
TELEPHONE NUMBER WITH AREA CODE
(PRINT OR TYPE)
Applications are to be submitted online at dnr.mo.gov/fundingoppportal.htm. For questions or issues regarding the online submission,
contact the Section 319 Nonpoint Source Unit at 573-751-4932.
MO 780-1896 (03-19)
FOR OFFICE USE ONLY
MISSOURI DEPARTMENT OF NATURAL RESOURCES
DATE RECEIVED
SOIL & WATER CONSERVATION PROGRAM
NONPOINT SOURCE IMPLEMENTATION GRANT APPLICATION
ALL DOCUMENTATION RECEIVED
Yes
No
1. SPONSORING AGENCY INFORMATION
A. NAME OF SPONSORING AGENCY
B. HAS THE SPONSOR RECEIVED ANY PREVIOUS SECTION 319 GRANTS?
YES
NO
C. SPONSORING AGENCY’S MAILING ADDRESS (STREET, CITY, STATE, ZIP CODE)
D. DOES THE SPONSORING AGENCY HAVE ANY OTHER OPEN 319 GRANTS?
YES
NO
IF YES, PROVIDE THE PROJECT TITLE AND PROJECT NUMBER:
E. SPONSORING AGENCY TYPE (CHECK ONE)
F. SPONSORING AGENCY INFORMATION
EDUCATIONAL INSTITUTION
SPONSOR FEDERAL TAX ID NUMBER:
NONPROFIT 501(C)(3)
DUNS NUMBER:
GOVERNMENT: SPECIFY:
CONGRESSIONAL DISTRICT NUMBERS:
H. PROJECT MANAGER CONTACT INFORMATION (IF DIFFERENT FROM PRIMARY CONTACT)
G. PRIMARY SPONSOR CONTACT (NAME, TITLE, TELEPHONE NUMBER WITH AREA
CODE, FAX NUMBER WITH AREA CODE, E-MAIL ADDRESS)
2. PROJECT INFORMATION SUMMARY
A. NAME OF PROJECT
B. PROJECT START DATE (MM/DD/YYYY)
C. PROJECT END DATE (MM/DD/YYYY)
D. NAME OF WATERSHED PLAN BEING IMPLEMENTED AND THE YEAR IT WAS ACCEPTED BY EPA
E. PROJECT BUDGET SUMMARY
Federal Budget
Section 319 Federal
Nonfederal Match
Other
Categories
Funds Requested
[(40/60) x (319 Funds Requested)]
Match
Salary
See note in application instructions
regarding administrative cap
Fringe
Travel
Equipment (over $5,000)
Supplies
Contractual
Other
Approved Indirect (
%)
$
$
$
Totals
(verify all calculations)
3. SPONSORING AGENCY’S AUTHORIZED SIGNATURE AND APPROVAL OF APPLICATION
To the best of my knowledge, all the information in this application is true and correct. The documentation has been duly authorized by the
governing body of the applicant. As the authorizing representative I attest I have read the required documents and assure I can and will
comply with all requirements and conditions of this grant if awarded.
NAME AND TITLE OF AUTHORIZED ORGANIZATION REPRESENTATIVE
SIGNATURE
TELEPHONE NUMBER WITH AREA CODE
(PRINT OR TYPE)
NAME AND TITLE OF APPLICANT OR PROJECT MANAGER
SIGNATURE
TELEPHONE NUMBER WITH AREA CODE
(PRINT OR TYPE)
Applications are to be submitted online at dnr.mo.gov/fundingoppportal.htm. For questions or issues regarding the online submission,
contact the Section 319 Nonpoint Source Unit at 573-751-4932.
MO 780-1896 (03-19)
4. PROJECT WATERSHED
IS THE PROJECT AREA COVERED BY AN EPA ACCEPTED NINE
ELEMENT WATERSHED BASED PLAN OR TMDL?
ENVIRONMENTAL
USGS 12-DIGIT HUC
WATERSHED NAME
COUNTY
JUSTICE PRIORITY
NUMBER
RANK (IF KNOWN)
TMDL
WATERSHED BASED PLAN
YES
NO
YES
NO
5. PROJECT TYPE
A. CHARACTERIZE YOUR PROJECT USING THE FOLLOWING GENERAL STATEMENTS. SELECT ALL THAT APPLY.
Stream and/or Riparian Restoration and Protection
Lake Management and Restoration
Stream Obstruction Removal/Modification
Abandoned Mine Stream/Drainage Mitigation/Restoration
Wetland Restoration and/or Protection
Agricultural Best Management Practices
Innovative Stormwater Demonstration
Note: Proposed projects within an area served by an MS4 permit must
provide proof that activities are above and beyond permit requirements.
C. CHOOSE A CAUSE OF IMPAIRMENT STATEMENT THAT BEST CHARACTERIZES THE PROPOSED
B. CHOOSE ONE ENVIRONMENTAL GOAL STATEMENT.
PROJECT.
Project is designed to restore or improve impaired waters
Project addresses habitat or hydro-modifications impairments
Project addresses silt/sediment impairments
Project is designed to reduce nonpoint source pollution
Project prevents nonpoint source pollution
Project addresses nutrient caused impairments
Project addresses impairments caused by mine drainage
Other (please specify):
Project addresses bacteria caused impairments
Project addresses impairments caused by other nonpoint
sources (please specify):
D. NAME OF IMPAIRED WATER BODY(IES) ADDRESSED AND WATER BODY ID(S) (IF KNOWN):
6 a. PROJECT IMPLEMENTATION WORK PLAN NARRATIVE
Directions:
The project work plan narrative should provide a concise and detailed description of the proposed project, including all specific actions that will
be conducted to ensure successful implementation. At a minimum, be sure to include the “who, what, when, and how” of project completion. The
implementation work plan narrative should include the following information:
• Responsible party, if other than the applicant.
• Statement identifying the nonpoint source pollution and/or problems that this project is designed to address.
• Description of current environmental conditions
• A very brief description of the project (specific land management practices narrative and project deliverables to be provided in parts 6 b and c) and
the anticipated environmental outcomes and measures of success.
• A description of the means that will be used to permanently protect a restored project site (e.g. ordinances, easements, maintenance agreements,
etc.).
• Provide a detailed description of the project site. This should include site location, environmental conditions, accessibility, ownership, etc., and include
maps, and relevant pre-condition site photos.
• If the project is implementing a cost-share program (i.e., providing funds to landowners for BMP implementation), provide the following information:
Methods for identifying areas of known problems.
o
Methods for focusing practices in specific problem areas.
o
The process for prioritizing cost-share participants.
o
The maximum amount and percentage of cost-share for each project or land management practice implemented.
o
The process for certifying satisfactory installation prior to making payment to landowner.
o
The method for insuring the management practice will be maintained properly for the life of the management practice (inspection, operation,
o
and maintenance agreements, etc.).
Note: If state cost-share or EQIP/CSP, etc., is used just state the program being implemented.
o
• Explain how the success of the project will be evaluated and measured.
• How will pollutant load reductions be reported and how does it directly relate to the pollutant load reductions stated in the watershed based plan or
total maximum daily load (TMDL).
• Note the page and section number from the approved watershed based plan that describes the need for the project being implemented.
DETAILED PROJECT WORK PLAN NARRATIVE (ADD ADDITIONAL PAGES AS NEEDED IN AN ATTACHED WORD DOCUMENT)
MO 780-1896 (03-19)
DETAILED PROJECT WORK PLAN NARRATIVE (ADD ADDITIONAL PAGES AS NEEDED IN AN ATTACHED WORD DOCUMENT) - CONTINUED
MO 780-1896 (03-19)
DETAILED PROJECT WORK PLAN NARRATIVE (ADD ADDITIONAL PAGES AS NEEDED IN AN ATTACHED WORD DOCUMENT) – CONTINUED
6 b. NARRATIVE DESCRIPTION OF THE LAND MANAGEMENT PRACTICES TO BE IMPLEMENTED
Directions:
For each type of management practice to be implemented, provide a brief explanation why the type of management practice was selected, and
the targeted location(s) the practice is to be implemented. Reference the page and/or section number of the EPA accepted watershed based plan where the
prescribed need for these practices can be found.
DETAILED NARRATIVE DESCRIPTION OF BMPs TO BE IMPLEMENTED (ADD ADDITIONAL PAGES AS NEEDED IN AN ATTACHED WORD DOCUMENT)
MO 780-1896 (03-19)
DETAILED NARRATIVE DESCRIPTION OF BMPs TO BE IMPLEMENTED (ADD ADDITIONAL PAGES AS NEEDED IN AN ATTACHED WORD DOCUMENT) – CONTINUED
6 c. PROJECT IMPLEMENTATION DELIVERABLES WORKSHEET
When requesting Section 319(h) grant funding to implement land management practices, you MUST complete the Project Deliverables
Directions:
Worksheet in addition to the detailed project work plan narrative. Use of Section 319(h) grant funds must be appropriate to the area and address the water
quality impairment or water quality concern as stated in the U.S. EPA accepted watershed based plan. Section 319(h) grant funds cannot be used to
implement regulatory permits, for land purchases, or to conduct research. Add additional pages as needed in an attached Word document. If an
“Other” load reduction is reported, please include the information in the narrative section.
Deliverables
Expected
Estimated Load Reductions
Estimated
Associated with
Deliverable
Deliverable
Total
Total
Project Activity
Cost
Sediment
Bacteria
Proposed Project
Units to be
Units
Nitrogen
Phosphorus
$
& Units
& Units
Activity
Completed
& Units
& Units
CALCULATE
$
TOTAL ESTIMATED COST OF BMP IMPLEMENTATION
TOTAL LOAD
REDUCTIONS
MO 780-1896 (03-19)
Page of 14