WATER RESOURCES COST-SHARE (grant) PROGRAM APPLICATION

Initial fiscal year 2009 sign-up period: March 1 to March 31, 2008

*Landowner certifies that there is a minimum of 40 acres of pasture AND a grazing management plan must be completed by NRCS and accepted by the landowner to receive cost-share funds.  Falsified information results in repayment of cost-share funds.  Construction may not begin until application has been approved. If you receive cost-share funds exceeding $600.00 you will receive a 1099 from the State of Kansas. Any applications returned with coffee &/or donut stains must be accompanied by a cup of coffee &/or donut (preferably fresh). ==============================================================================

TRUST NAME:__________________________________________________________     OR OWNER NAME:_________________________________________________________ MAILING ADDRESS:_____________________________________________________ CITY:________________________________ ZIP:______________________________ OPERATORS NAME:_____________________________________________________ MAILING ADDRESS:_____________________________________________________ CITY:________________________________ ZIP:______________________________ OWNER SOCIAL SERCURITY # OR TRUST EIN #____________________________ PHONE:________________________________________________________________ LEGAL DESCRIPTION: NW NE SW SE 1/4 OF _____-______-_____TRACT#______

Buffer strips # acres _________________ Diversion # acres ____________________ Feed lot windbreak # tree_____________ Grade stabilization structure___________ Grassed waterway # acres____________ Grassed waterway restoration # acres___ Critical area planting # acres___________ Fencing # feet______________________ Pipeline # feet______________________ Mulching # feet_____________________

Livestock well # feet (estimate) _____________________ New pond   (circle one) Pit     or     Embankment # cubic yards (estimate) ______ Range seeding # acres ____________________________ Spring development_____________________________ Terrace # feet__________________________________ Terrace restoration # feet_________________________ Waste control Facility____________________________ Waste treatment lagoon size _______________________ Tank or trough Type/size_________________________

GRAZING MANAGEMENT PLAN INFORMATION: What months do you graze?_________________________________________________

Type and number of animals you are currently grazing: Cow, dry #____ Horses, mature #____Cattle, 1 year old #____ Goat, mature # ____ Cow, with calf # ____Sheep, mature # _____Cattle, 2 year old #_______ Kid, 1 year old # ______ Bull, mature # ______Lamb, 1 year old #_______ Bison, with calf #_______ Bison, mature #_____

This evaluation is used to prioritize applications for state cost-share funds to be expended for the improvement of water quality.                  Points Score Practice within High Priority Areas     Practice located In Smokey Hill SW Priority area      15 _____ Practice located in Solomon medium priority area      10 _____ Project Type Priority Pasture and Rangeland Management                         25 _____ Erosion Control                                                         20 _____ Riparian Area Protection                                           15 _____ Rural Fire Protection                                                 10 _____    Distance to perennial stream Practice located within 100 feet                                       10 _____ Practice located more than 100 feet less than 300 feet      8 _____ Practice located more than 300 feet less than 500 feet      5 _____ Complete this section for all projects that are applicable Site is less than ˝ mile from perennial water source       15 _____ Pasture 80 acres or larger                                                 10 _____ Land is classified as highly erodiable                                 5 _____      Computed by: _____________________________Date: ______________Total Score:________ ========================================================================= This form is an application for cost-share assistance.  I understand completing this form does not guarantee approval for funds. Landowner’s Signature: X________________________________________