Sabine River Authority of Texas

FY-2008 Community Assistance GRANT Program

Application Form

Each entity must submit a completed Community Assistance Grant Application form to be considered for FY-2008 funding. The form must be postmarked or faxed (to meet deadline) no later than September 19, 2008. If faxed, the original must be sent by mail. Forms postmarked after the September 19, 2008 deadline will not be accepted.

(Please type or print the requested information below)

Entity Information

Name of Entity (County/City/District etc.) 

Address

County

City State ZIP Code

Contact Person

FAX No.

Telephone No.

Email Address

Project Description Provide a brief description of the Project.  Refer to Grant Application Instructions for details.  Additional sheets may be added if needed.

 

 

 

 

 

 

 

 

 

 

 

 

 

Project Category  - costs could include feasibility studies, materials or construction costs for:

Check one Category that best describes the purpose of the Project

A. Water Supply System – Permitted capacity of a Water Supply System is being expanded or additional facilities are needed for growth. 

 

B. Wastewater Management – Permitted capacity of a Wastewater Treatment System is being expanded or additional facilities are needed for more stringent limits.

 

C. Water Conservation - Promotes or improves water use efficiency. 

 

D. Water Quality - Promotes or improves instream water quality.

 

Requested Amount: (up to $10,000)

$_________________

Local Commitment: (Amount of Local Funds)

$_________________

In-Kind Services: (Describe and value)

 

$_________________

Other Sources of Funds: (Describe)

 

$_________________

Total Project Costs:

$_________________

Links to Other State/Federal Loan or Grant Programs:  (Identify program and status of approval)  

 

Signature of Legally Authorized Public Official

Printed Name and Title of Applicant’s Authorized Representative

 

 

Phone Number:

Signature of Authorized Representative

 

 

Date:

 

Mail

1)     Completed application

2)     Supporting documentation

3)     Map of project area

Sabine River Authority of Texas

Community Assistance Program

P. O. Box 579

Orange, TX  77631

Address questions to:

Ann Galassi

Phone:   409-746-2192

Fax:        409-746-3780

Email:     agalassi@sratx.org