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msd-proj_clear_WEB_app-onlyMSD Project Clear | 17 MSD PROJECT CLEAR RAINSCAPING SMALL GRANTS APPLICATION – Application, page 1 of 4 – - CONTACT INFORMATION & SCOPE OF PROJECT Name Phone Number Address City State Zip Email address 1. Did you attend a required landowner orientation? Yes No Date of orientation ______________________________________ 2. Project is (check one): Residential Institutional/Commercial Multifamily (includes businesses, schools, governments, churches, etc.) 3. Type(s) and size(s) of rainscaping to be installed; check all that apply. (Go to www.mobot.org/rainscaping for step-by-step rainscape planning guidance. NOTE: choose a box for each separate rainscaping feature you are implementing; multiple checked boxes mean multiple features are being proposed.) Native soil rain garden: sq. ft.; ponding depth; perc. test results (inches/hour drained) Engineered bioretention: sq. ft.; ponding depth; perc. test results (MSD Permit Required*) (inches/hour drained) Lawn alternatives: sq. ft. (replace turf grass or invasives with trees and groundcover, shrubs, perennials and/or prairie plants) Permeable pavers: sq. ft.; # of base layers; total inches of base layers perc. test results (inches/hour drained) Rain barrel(s) or cistern: gallons Bioswale(s): sq. ft. Woodland restoration: sq. ft. (invasive species removal and replacement) Green roof: sq. ft. Other: *To obtain an over-the-counter MSD permit, contact Engineer of the Day at (314) 768-2705. 4. Is your rainscaping feature replacing one or more of the following? (NOTE: existing landscaped areas are NOT eligible) Lawn grass: Yes No Bare ground: Yes No Invasive species*: Yes No Pavement: Yes No Other; please explain: *For a list of invasive species, see www.mobot.org/rainscaping. 18 | Rainscaping Small Grants Program Landowner Handbook Materials/Items (plants, soil, gravel, etc…) All plant species must be noted separately Source (attach source if not on official bid) Plant Genus and Species Common Name Quantity Price per item/ plant Total price Spacing Container Size Native (Yes or No)Additional Information $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ Materials Total $ Design* Total $ Labor* Total $ Project Total $ Amount Requested for Award $ Landowner Match and/or Costs that will not be covered by the Program $ BUDGET – Application, page 2 of 4 – MSD Project Clear | 19 Materials/Items (plants, soil, gravel, etc…) All plant species must be noted separately Source (attach source if not on official bid) Plant Genus and SpeciesCommon Name Quantity Price per item/ plant Total price Spacing Container Size Native (Yes or No)Additional Information $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ $$ Materials Total $ Design* Total $ Labor* Total $ Project Total $ Amount Requested for Award $ Landowner Match and/or Costs that will not be covered by the Program $ – Application, page 3 of 4 – 20 | Rainscaping Small Grants Program Landowner Handbook – Application, page 4 of 4 – OUTREACH 5. Will you allow MSD Project Clear to use pictures and/or information from your project in public outreach efforts or publications? Yes No 6. Please note that design and labor costs can only be included if a participating contractor is employed. If do-it- yourself (DIY) design and/or installation is employed, labor costs cannot be reimbursed. Therefore, equipment rental for DIY projects should be listed under materials. In addition, an itemized materials list including the cost per item per feature must be attached. 6A. Who designed the landscaping? (check one): Do-it-yourself Contractor 6B. Who will install the landscaping? (check one): Do-it-yourself Contractor 6C. If using a contractor, name those that you plan to or have solicited bids from: ____________________________ ______________________________________________________________________________________________ 6D. Who will maintain your feature?_________________________________________________________________ ATTACHMENTS — (IMPORTANT: Clearly label each attachment with your name and address.) You MUST include TWO copies of application and respective attachments: If requesting contractor-installed project, please include bid on contractor letterhead. If installing a DIY project, please print off copies of any online pricing you have sourced. Soil amendment strategy (if applicable) including—mulch: what kind, how thick, where from; if compost applied: quantity (in inches), what kind, where from; if aeration method is used: type of aerator and depth of aeration in inches. Landscape design drawing(s)/planting plan(s). (See Landscape Drawing Requirements.) Photograph(s) of your site. Please including the following: (1) Show exact future location(s) of your rainscaping feature(s) (we must be able to see what is currently in the location where you intend to add a rainscaping feature); (2) Show proximity of the feature(s) to the street; (3) Include descriptive labels on all photos; (4) Include aerial photograph or aerial satellite image from Google Maps; (5) Loose photos must be attached to an 8½” × 11” piece of paper. Maintenance plan (specify who will take care of the plan) Dig Rite photos or appointment paperwork or receipt BONUS: Include project narrative/description. SIGNATURE/AGREEMENT • I have read and agree with all MSD Project Clear Rainscaping Small Grants Program requirements. • I agree to maintain the rainscaping feature(s) for a minimum of five years, including watering plants during the establishment phase, weeding, pruning, annual mulching, and plant replacement as needed. • I do not intend to sell my house at this time. • I understand that this program is partially funded with public money, therefore names, addresses, and project data may be shared with partners as requested. • I understand that the Rainscaping Small Grants Program parameters and RainScaping Guide are provided as guidelines only. Landowners are solely responsible for ensuring the success of their own rainscaping feature designs and implementations. Grant application review and acceptance for funding does not imply program, funder, or partner endorsement or responsibility for proper design, installation, or maintenance. Landowner signature (signature required even if not overseeing the project) Print name