SMALL WATER DEVELOPMENT PRODUCER APPLICATION



APPLICATION FOR THE SMALL WATER PROJECT PROGRAMWyoming Water Development Commission6920 Yellowtail RoadCheyenne, WY 82002(307)777-7626PROJECT NAME: ____________________________________________________________________________________________________________________________________________(Applicant – Name of Entity)______________________________________________________________________________(Contact Name)_________________________________ __________________ _______ ____________(P.O. Box or Street Address) (City) (State) (Zip)____________________ _____________________ _______________________________(County) (Phone)(Email) Type*QuantityNew DevelopmentRehabilitationLatitude(Required)Longitude(Required)Small ReservoirWellSolar PlatformsPipelineTankSpring DevelopmentWetlandEnvironmentalIrrigationWindmill* The project types listed in the above table will be considered eligible as defined by the Small Water Projects Program Criteria. Environmental projects are defined as those that provide for stream bank stability, water quality improvements, or erosion protection.Legal Description (Optional)_________________ ___________________________________ _______________ (Township) (Range) (Section) (Quarter Section)_________________ ___________________________________ _______________ (Township) (Range) (Section) (Quarter Section)_________________ ___________________________________ _______________ (Township) (Range) (Section) (Quarter Section)_________________ ___________________________________ _______________ (Township) (Range) (Section) (Quarter Section)Project Description:Planning for small water projects will be generated by a WWDC watershed study or equivalent as determined by the Wyoming Water Development Office. Provide all information necessary to accurately describe the proposed project and its eligibility per operating criteria. Additional information may be attached to this application as necessary.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Public Benefit:Wyoming statute 99-3-1903(k)(viii)(c) and 99-3-1904(m)(viii)(c) requires all small water project sponsors to substantiate the public benefit that is to be derived from the proposed project. Please provide all information necessary to accurately document public benefit from the proposed project. Additional information may be attached as necessary.__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Project Participants:Please list all project participants (District, NRCS, WWNRT, BLM, Landowner, etc.), and their type of participation (Technical, Financial, project oversight, etc.).____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Who is the owner of the project? __________________________________________________Who owns the land that the project is to be built on? _________________________________Which WWDC Watershed Study Boundary is this project within? ________________________ ______________________________________________________________________________ How many acres will be benefited by this project? ____________________________________What is the total estimated project cost? ___________________________________________Project Readiness:Projects that have completed the following requirements prior to application may request a “Shovel Ready” designation, and may be considered as a funding priority at the Commission’s discretion.Certified project design and specificationsPermit procurementState and Federal Agency NotificationsLand Procurement, Right of Way, or Easement acquisitionHave finalized all other financial agreementsTo indicate an interest in seeking a Shovel Ready Designation please complete the Project Sponsor Checklist, well evaluation and hydrologic evaluation forms available at and attach to this application. Additionally, please list below all supporting documentation that is being attached. (If the Sponsor is not seeking a Shovel Ready Designation then following section may be left blank.)______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________The Sponsor understands and agrees with the conditions set forth in the operating criteria of the Small Water Project Program.APPROVED: (Sponsor Representative)DATE: ................
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