ࡱ> :<9 @  bjbjqq !&8$(BBB`bbbbbb$R-BB   LBB` `  :,B `-#{ L <$0 l|81 ? K "Drinking Water Revolving Fund (DWRF) Small Community Planning Loan Application Michigan Department of Environmental Quality Jennifer Granholm, Governor Steven E. Chester, Director  http://www.michigan.gov/deq 517-373-2161 This application may be submitted for a water supply system serving a population under 10,000 persons. The maximum amount of a Planning Loan is $100,000, with a maturity of five (5) years. DWRF Project Name ____________________________________________________________ DWRF Project No. ______________________ Legal Name of Applicant _______________________________________________________________________ The legal name of the applicant may be different than the name of the project. For example, a county may be the legal applicant for bonding purposes, while the project may be named for the particular village or township it serves. Address of Applicant _______________________________________________________________________Street, P.O. Box) _______________________________________________________________________ (City, State & Zip) _______________________________________________________________________ (Area Code and Telephone Number) (Fax Number) Authorized Representative Name __________________________________________________________________ Title ___________________________________________________________________ _______________________________________________________________________ (Street, P.O. Box) _______________________________________________________________________ (City, State & Zip) _______________________________________________________________________ (Area Code and Telephone Number) (Fax Number) In accordance with MCL324.5404(3)(b) and 2000 Act 147, the above municipality hereby applies for a Small Community Planning Loan. Eligible project planning costs must be directly related to the proposed waterworks project and not incurred prior to June 17, 1997. Eligible planning costs include: Archaeological Surveys Environmental Audits of Project Sites (Phase 1) Hydrogeological Studies Project Plan Preparation and Submission Public Participation Activities Public Hearing Transcripts Reliability Studies Vulnerability Assessments Amount of Small Community Planning Loan Requested $________________________ Please attach copies of applicable Engineering Agreement(s) and invoices totaling the amount requested. As the Authorized Representative of the applicant, I certify and/or agree to the following: 1. The proceeds of this loan will be applied to reimburse incurred planning costs related to the proposed project. There are no outstanding fines or prior year fees as prescribed in 1976 Act 399 as amended. The water supply system of the applicant has a population served of less than 10,000 people. In the event the municipality qualifies and receives a grant as a disadvantaged community under MCL324.5404(3)(c), the outstanding principal of this Small Community Planning Loan and accrued interest will be due and payable 30 days after receipt of such grant. The term of the planning loan shall not exceed five years. The interest rate shall be the same as the DWRF for the year said planning loan is originated. Payments are due October 1 of each year for the life of the loan. _____________________________________________________________________________ Signature of Authorized Representative (Original Signature Required) Date Please submit this application with the specified Engineering Agreement(s) and invoices to: REVOLVING LOAN AND OPERATOR CERTIFICATION SECTION ENVIRONMENTAL SCIENCE AND SERVICES DIVISION MICHIGAN DEPARTMENT OF ENVIRONMENTAL QUALITY PO BOX 30457 LANSING MI 48909-7957 PAGE 2 PAGE 1 %P}   1 ~ g | (+,0?Kpqxy12Tɿɸɲɬɬɬɬɬɲɬɛɕɏ h/j@ hY@ hP6@h 6@OJQJ h 6@ hPCJ hP5@hP@OJQJ hP@ h/jCJ hPCJjhPCJU hPCJ hYCJ hP5hP hPCJ6%P}    3 4 } ~ f g |  00*$^`0  !0*$ 0*$$a$| } ! 6 7 S T G\]@A $*$ 00*$^`0 0*$AX12FGuv|}[ & F 0*$ 00*$^`0 0*$ & F 0*$[\ST &`#$ $ 0*$a$ H*$ 0*$    ĺīĺҧhPhTWhTW0JOJQJmHnHuh 60JOJQJjh 60JOJQJUh 6jh 60JU*h 60JmHnHu* h 60Jjh 60JU0/ =!"#$%tDdn <  C Abr?ދj֍CDnr?ދj֍CPNG  IHDRn5gAMAPLTE*?*?*_*_U*_*_**U****U****U****U*ߪ***U**UUUUUUUUU?U?UU?U?U_U_UU_U_UUUUUUUUUUUUUUUUUUUߪUUUUUU??U??U__U_U_UUUUߪUUUU?U?U??__U__UUUUߪUUU??U??__U__UԟԟUԟԟԿԿUԿԿUߪUUU??U??__U__UUUUߪU3fUUUUߪU**U****U***?*?U𠠤>@ pHYs.#.'r=IDATxے0 CfebIVK֖tv{zk_6M)zJղ&PUx}͟I+(tjX +HT<_xuϾʞOM2IRb͖GLrbE5[sH[95k*N_mL E8£2<ȭk<":?'o2?3oAGLwފA>ݤx lc&Z#]zQ 8;K/4lk+"PIG3ehyvGw9W8aig7?\0i|~Y@bh5"UGͯW^?{艋cx_L`IYXĨOXצ~K=4?{i~ G._{ReOW0F2^7HDP;5~$AފgCN~Um+ 4$StK|4]i/Gxq6Z9[<~AZ R(@GR<~KfkתKrጛ>"N:>- do/g +dFߵJ| )| :r>i#=ʏ\㪖%rN*?EzH9i4=&m+C)"_6ڵ׮Ϳvmk]ZDkIENDB`D@D NormalCJOJQJ_HmH sH tH B@B Heading 1$$@&a$5CJ^@^ Heading 2&$ 00*$@&^`0 5@CJb@b Heading 3)$ 0`*$@&^`` 5@CJL@L Heading 4$*$@& 0 5@CJ>@> Heading 5$$@&a$CJ$DA@D Default Paragraph FontViV  Table Normal :V 44 la (k(No List <@< Header  !OJQJ< @< Footer  !OJQJ.)@. 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