Project Application for Level III Construction Funding - Agricultural Projects

In order to receive consideration for Level III construction funding, the project sponsor must be an entity of local government with taxing and/or assessment authority. Private corporations and individuals are not eligible for assistance. Note: If you are seeking Level III funding for a project new to the Program, you must provide a feasibility study with detailed cost estimates prepared by a professional engineer registered in the State of Wyoming.

ENTITY INFORMATION

(Type of Entity - i.e.: Irrigation District, Conservancy District, etc)

Year of Formation:
Applicant - Name of Entity
Address: Phone:
City/Town: State: Zip Code: County:

(Authorized Official)
(Contact Person)
(Contact Phone)*

*The best time to reach the contact person is from to o'clock on days of the week.
Email for Contact Person

If the application was prepared by someone other than the contact person, please provide:

(Name) (Phone Number) (Email)

PERTINENT INFORMATION

The purpose of this section is to gather information necessary for the development of the financing plan for the Level III construction project. Answer all questions as completely and accurately as possible. If you need help, please call the Water Development Office at 307-777-7626.

A. REQUESTED FINANCING PLAN Provide the following specifics regarding the financing plan you are seeking. Contact the WWDO for questions regarding specifics relating to existing Program criteria.

1. Provide a brief statement describing the project for which you are seeking funding, including the reasons the project is needed. Describe the current situation with your water supply that will be improved by the project. (Attach additional information if you wish):

2. Total funding request (please attach the best available detailed cost estimate):

3. WWDC Grant (Percentage of total WWDC eligible project costs):

4. WWDC Loan (Percentage of total WWDC eligible project costs):

a. Interest rate (presently, the typical rate is 4%):

b. Term of Loan (cannot exceed economic life of project or 50 years, whichever is less):

5. If you are planning to obtain alternate loans or additional grants from other agencies to supplement your request from the WWDC, please describe your financing plans and the schedule for the acquisition of the funds:
6. Total project costs not eligible for WWDC funding:
7. Please describe your financing plans and the schedule for the acquisition of the costs not eligible for WWDC funding
8. Does the Sponsor have the authority to adequately assess fees or collect funds to cover operation and maintenance expenses related to the water development project? Yes No

B. EXISTING WATER SUPPLY SYSTEM
1. Description of Direct Flow Supply:

a. Direct flow diversion right in cubic feet per second:

b. Direct flow source (Name of river, stream, etc.):

c. Type of diversion (Gravity headgate, pumps, etc.):

d. Water transmission system (Canal, pipeline, etc.):

2. Description of Stored Water Supply:

a. Name of storage facility (reservoir):

Location:

b. Amount of stored water right in acre-feet:

c. Is any of your supply received from a federal facility? Yes No

Percent of total supply:

d. Acre feet from federal facility:

Name of federal facility:

3. Description of Groundwater Supply:

a. Number of wells:

b. Maximum well depth:

Minimum well depth:

c. Total production capacity of all wells in gallons per minute:

4. What type(s) of on-farm irrigation water application is used-center pivot, side roll, flood, etc.
5. Briefly describe the main crops and cropping patterns:
6. Describe the water measuring devices currently in use:

7. Percentage of farm turnouts with measuring devices:

Are water deliveries recorded? Yes No

C. FINANCIAL INFORMATION

1. Service Area Information

Pre-Project Post Project

a. How many total acres are in the District?

b. How many acres are assessed?

c. How many acres are irrigated?

d. What is the annual water delivery in acre-feet per acre assessed?

e. How many individual landowners receive water?

2. Water Usage:

Pre-Project Post Project

a. Estimate the total water (AF) provided by your system annually:

b. Average Day Demand (AF):

c. Peak Day Demand (AF):

3. System Capacity:

Pre-Project Post Project

a. Maximum capacity of the water supply system (acre feet per day):

b. Increased capacity needed (acre feet per day):

c. Estimated system water losses (percentage):

d. Identify the water rights, existing or needed, for the project. Describe the status of the water rights (eg. filings, permits, adjudicated water rights):

e. What is the factor (bottleneck) that is presently limiting your ability to provide water (supply, canals, etc.):

f. What will be the post-project factor (bottleneck) that will limit your ability to provide water (supply, canals, etc.):

g. Describe water conservation efforts (canal-lining, on-farm pivots, etc.):

4. District Financing

a. Is your assessment based on acres, acre-feet delivered, acre-feet of storage space, or other:

b. How is voting authority delegated to water users? (shares, individuals, number of acres, etc.) :

Pre-Project Post Project

c. What is the per unit amount of the current assessment?

d. If there is a basic service charge or first acre assessment in addition to assessments, how much is it?

5. Financial Statement

Pre-Project Post Project

Annual revenues generated from assessments:

Annual revenues from other sources:

Total annual revenues:

Annual payments for debt retirement:

Annual budget for typical operation and maintenance expenses:

Annual payments to a repair and replacement fund:

Annual payments to an emergency fund:

Annual payments for other purposes:

Total annual payments:

Balance in repair and replacement fund:

Balance in emergency fund:

Explanation (if needed):

Is the operation of the water supply system self supporting in terms of revenues offsetting costs for operation, maintenance, debt retirement, replacement funds and emergency funds?

If not, how is the difference subsidized?

D. CONSTRUCTION DELIVERY METHOD

1. Please indicate the construction delivery method the Sponsor will use if the project is approved by the legislature. Please talk to your attorney if you have questions about the construction delivery methods.

Design-Bid-Build
Design-Build
Construction Manager At Risk

If you wish to retain a copy of your form, please print this page before pressing the Submit Information button below

Thank you for your participation!
Dept. 3943 | 1000 E. University Ave. | Laramie, WY 82071
Office: (307) 766-6651 email: wrds@uwyo.edu

PROJECT APPLICATION FOR LEVEL III CONSTRUCTION FUNDING
FOR AGRICULTURAL PROJECTS

WYOMING WATER DEVELOPMENT COMMISSION
6920 Yellowtail Road
Cheyenne, Wyoming 82002
Telephone: (307) 777-7626 Fax: (307) 777-6819

If you wish to retain a copy of your form, please print this page before pressing the Submit Information button below

PROJECT APPLICATION FOR LEVEL III CONSTRUCTION FUNDING FOR AGRICULTURAL PROJECTS

WYOMING WATER DEVELOPMENT COMMISSION 6920 Yellowtail Road Cheyenne, Wyoming 82002 Telephone: (307) 777-7626 Fax: (307) 777-6819

If you wish to retain a copy of your form, please print this page before pressing the Submit Information button below

PROJECT APPLICATION FOR LEVEL III CONSTRUCTION FUNDING
FOR AGRICULTURAL PROJECTS

WYOMING WATER DEVELOPMENT COMMISSION
6920 Yellowtail Road
Cheyenne, Wyoming 82002
Telephone: (307) 777-7626 Fax: (307) 777-6819