1、. PRELIMINARY APPLICATIONLand and Water Conservation FundGrant Program This application must be received in the State of Alaska Division of Parks office by 5:00 PM on Friday, February 1, 2013. To be considered for funding, all required information must be included in this Land and Water Conservation

2、 Fund (LWCF) preliminary application. If a preliminary application is prioritized high enough to receive funding, a full application and further information will be required.Submit this preliminary LWCF grant application to: Jean Ayers, Grants Administrator State of Alaska: Dept of Natural Resources

3、 Division of Parks and Outdoor Recreation550 W 7th Avenue, Suite 1380Anchorage, AK 99501-3561 If you have questions about this grant program, the application process, or completion of forms, e-mail the LWCF grants administrator at or call 907-269-8694. Applicant: Use the checkli

4、st below to ensure all required submittals for your project type. Proposed Project Name and Location: _ Project Type: _ Development _ Acquisition _Combination Acq/DevChecklist for Development Projects Checklist for Acquisition Projects1. Qualifying Criteria and Certification1. Qualifying Criteria an

5、d Certification2. Project Narrative2. Project Narrative3. Geographic Location Map3. Geographic Location Map4. Project Boundary Map 6(f)(3)4. Project Boundary Map 6(f)(3)5. Site Plan 5 . Future Development Plan 6. Land: Title or Deed6. Land: Appraisal, if available 7. Budget 7. Budget8. Acquisition S

6、ummary1. QUALIFYING CRITERIA and CERTIFICATION Qualifying Criteria: The following are basic eligibility requirements an applicant must meet to be eligible for a grant from the Land and Water Conservation Fund (LWCF) program. A response of NO to any of the following questions will automatically disqu

7、alify an application.1.Is the project type identified in the SCORP as a priority?YES NO2.Is the application submitted by one of the following entities?YES NO State entity with authority to provide outdoor recreation services on public lands, or Regional or local government with authority to provide

8、outdoorrecreation services on public lands. (Provide documentation to verify authority.)3.If this is a development project, is the land now owned by the sponsor? YES NO(Provide documentation to verify land ownership.)4.If applicable, have all past LWCF compliance problems been resolved? YES NO5.Does

9、 the applicant have a current Section 504 Self-Evaluation and YES NOTransition Plan or be willing to prepare one prior to receiving a grant?6. Will project development be accessible to persons with disabilities?YES NO7. Is the grant request (federal share) between $50,000 and $125,000?YES NOCertific

10、ation: On behalf of the below-named entity, I submit this preliminary application for the project described herein for consideration of grant assistance from the federal Land and Water Conservation Fund program. I acknowledge that substantial additional documentation will be required to complete a f

11、ull application, if this preliminary request is prioritized high enough to receive funding. Further, I agree to cooperate with the Alaska Division of Parks and Outdoor Recreation by furnishing all information necessary to qualify for federal aid, to execute a State/Local Agreement, and to adhere to

12、state and federal statutes governing the LWCF program.I am aware that this is a 50/50 matching grant program and I certify that match is available. I am also aware that the grant, if approved, will be paid on a reimbursable basis, and that any properties receiving LWCF grant assistance must be maint

13、ained, in perpetuity, for public outdoor recreation. I certify that to the best of my knowledge, the information in this application is true and correct. Authorized Representative (Print or Type) Direct inquiries on this application to: Name:Name:Title:Title: Address:E-mail Address:City & State:

14、Telephone: Zip Code:Date:Entity Name: Signature of Authorized Representative: 2. PROJECT NARRATIVE1.Approacha.What do you plan to do with the grant funds? Describe exactly what you plan to acquire or develop and how you expect to proceed with the project.b.Describe any unique features or special com

15、munity involvement. c.Give a detailed time schedule for completion of this project. d.What other agencies, organizations, consultants or individuals will be working on the project? Explain what they will be doing. e.Discuss your ability to operate and maintain the facility after acquisition/developm

16、ent.f.Discuss any future development plans.2.Objectives and Need for this Assistancea.Discuss how your proposal meets the priority needs identified for your region in the current Statewide Comprehensive Outdoor Recreation Plan (SCORP). b.Discuss your local or regional park a

17、nd recreation plan. Describe how your proposal ranks as a priority identified in that plan. c.Discuss public participation in your planning process. Discuss what community goal/s this project will assist in reaching. Provide information about how the community identified the need and any planning st

18、udies that highlight the problem. d.Why does your community need this particular project? Proive information about economic, social, financial, physical, institutional or other problems related to the need. Give examples of how people are adversely affected by the present situation. e.For acquisitio

19、n projects: Explain any particular urgency in acquiring the site. 3.Results or Benefits Expecteda.Who will benefit, and in what way, from this project? Be specific.b.How will this project help your community?4.Geographic LocationWhere is the project located in your community in r

20、elation to other public facilities and the area to be served by the project?5.Other - if applicableDescribe any other federal funds that are involved in this project or may be used in the future. 3. GEOGRAPHIC LOCATION MAPA map depicting the geographic location of the proposed project must be submit

21、ted with each application. Show the proposed project in relation to the community and include a North arrow. A street map, section map, or aerial view using Google Earth or a similar program is acceptable as long as there is enough detail (street names, local landmarks, etc) so that a person unfamil

22、iar with the area would be able to find the site. EXAMPLE4. PROJECT BOUNDARY MAP 6(F)(3)A signed and dated proposed project boundary map must be included with each application. This map must clearly depict the project boundary. Section 6(f)(3) of the Land and Water Conservation Fund Act requires tha

23、t no property acquired or developed with LWCF assistance shall be converted to other than public outdoor recreation use without the prior approval of the Secretary of the Interior. If the Secretary approves a conversion, other recreation properties of at least equal fair market value and reasonably

24、equivalent recreational usefulness and location must be substituted. Therefore, upon execution of an LWCF grant agreement , the area within the proposed or acquired project boundary will be committed to public outdoor recreation IN PERPETUITY. No development or activity can take place within the pro

25、ject boundary that is not outdoor recreation related. If such development or activity is planned or takes place, it triggers Section 6(f)(3) provisions. Because accepting LWCF funding is a perpetual commitment, describe the proposed project boundary carefully. Generally, the boundary will include th

26、e entire area of the park, open space or recreation area being developed or acquired. At a minimum, the area must be a viable public outdoor recreation area that is capable of being self-sustaining without reliance upon adjoining or additional areas not identified in the scope of the project. In no

27、case will the area covered by the conversion provisions be less than that utilizing LWCF assistance. An LWCF project places the entire area within the 6(f)(3) project boundary line under permanent LWCF protection and regulation. Therefore, any area on the site intended for non-recreational use will

28、have to be surveyed out and delineated on the map. The project boundary map will include the following:1.Project title.2.North arrow.3.Known outstanding rights, encumbrances or interests in the area held by others. Note area on map, and attach a narrative that explains any immediate or potential imp

29、act on the proposed use of the property.4.Legal description of the project area sufficient to identify the area afforded 6(f)(3) protection. 5.Signature of authorized representative.6.Date.Parcel Map: A parcel map must also be furnished for all projects. The map must show nearby street names, land u

30、ses, existing structures and natural features, and easements such as power lines or pipelines. The map must depict property lines, both for any contiguous recreation land and for the proposed project. Parcel numbers and area in acres per parcel must be shown. Indicate planned disposition or use to b

31、e made of any existing buildings. Non-recreational structures or uses will not be allowed within the identified 6(f)(3) boundary. Acquisition Projects: Parcel numbers must match the numbers shown on the Acquisition Information Summary. 5. SITE PLAN or FUTURE DEVELOPMENT PLANDevelopment Projects: Sub

32、mit a site plan showing all existing, proposed and future development. Project development proposed under this request must be clearly depicted. Existing development and future development should be noted as such. Identify all proposed and existing support facilities, and utilities such as power lin

33、es, underground water and sewer lines. If a phased project, provide a master plan for the entire site showing all proposed development. Note portions of the project that currently exist, the portions proposed for development in this request, and those planned for future development. Acquisition Proj

34、ects: Submit a map showing existing and future recreational use of the area to be acquired as well as any contiguous park land. Future uses do not have to be delineated exactly. They may be blocked in to show with reasonable accuracy the intended future location. The map need not be professionally drawn, but must be complete and accurate. Note: Separate maps are recommended for the Geographic Location Map, Project Boundary Map, and this Plan. However, one map may be submitted if it is large enough and detailed enough to depict a