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Green Blocks Pilot project Giving Conservation a Square Deal Household Application Thank you for your interest in the Missoula Green Blocks Pilot Project. To apply, please read and follow these instructions carefully. Once you complete this application and the Conservation Side Orders Menu, return them to the Block Captain who is organizing the overall application for your two-block area. Individual applications will not be accepted. Deadline: Your completed application should be submitted to the Block Captain by the time he or she specifies. That person must deliver a complete application packet by 3 p.m. Friday, August 13, to the Mayor’s Office at 435 Ryman St., Missoula, Montana 59802. Note that this is NOT a postmark deadline. Applications cannot be submitted online. What is Green Blocks? 1. Green Blocks Pilot Project Core Green Blocks is a partnership between the City of Missoula and NorthWestern Energy (NWE). The goal of the core program is to improve residential energy efficiency by: providing free home energy audits installing free energy-saving measures identified by those audits In addition, Mountain Water Company will provide free water-wise home audits and resulting water-wise measures and education. For a full list of energy-saving measures, see the “What Will Be Done To My Home To Save Energy” page included in this folder. 2. Green Blocks Conservation Side Orders The City of Missoula is excited to introduce a companion project to our Green Blocks partnership with NorthWestern Energy. Conservation Side Orders enhances the Green Blocks Core with a package of free City programs made specifically for Green Blocks participants that focus on: Clawson Windows - Energy Efficient, Locally Manufactured Replacement Windows First Interstate Bank Energy Efficiency Financial Assessment and Assistance Sustainable Building Systems Solar Site and Finance Assessment Pre-cycling/Recycling Missoula In Motion Transportation Options Planning Native and Waterwise Landscape “Grow Your Own Food” Education and Assistance Conservation Side Orders provides education and resources to help participants realize additional energy conservation, save money, and contribute to a more sustainable neighborhood and community. See the “Conservation Side Orders Menu” included in this packet for more detail. Green Blocks Pilot Project Scope: Green Blocks will engage 300 homes in two-block areas throughout Missoula’s diverse neighborhood network. Households must be clustered in “blocks.” Blocks are not necessarily defined by a square but must be adjacent streets that represent no more than an area equal to two square blocks. Two- block areas are required to have a 90% resident participation rate. For example, if there are 10 homes on a block, 9 must agree to participate. ---PAGE BREAK--- Household Application 2 Timeline: August 2010 - Applicants will be notified of committee decisions, including possible additional actions necessary for program inclusion. September 2010 – Mandatory Green Blocks Orientation meeting September 2010 – Audits will begin September 2010 – Conservation Side Orders program begins September – Completion – Conservation measures retrofits installed. 2010 – 2012 - Energy use monitored to note any benefits and changes. Note: All individual, household information about energy use will remain confidential; information will be used to quantify overall conservation efforts and for news media coverage. To Qualify: Complete application packet must be submitted by Block Captain. Households must be in the City of Missoula. Households must be clustered in “blocks.” Blocks are not necessarily defined by a square but must be adjacent streets that represent no more than two blocks. Two-block areas are required to have a 90% resident participation rate. For example, if there are 10 homes on a block, 9 must agree to participate. Households must be electric and natural gas customers of NorthWestern Energy. Account must be in good standing. Buildings must be residential. Areas with owner-occupied residences are preferred, although two-block areas with some rentals and multifamily units are welcome to apply (property owner permission required). Homes should use electricity or natural gas for their primary space heat. Single-family homes are preferred, but mixed neighborhoods are welcome to apply (this does not include mobile homes). Areas with predominant vintages are preferred. Homes built after 1990 are not eligible. All participants will be required to sign a participant agreement allowing access to the home and allowing the contractors to perform the work. Renters will need permission from their landlords. Likewise, tenants must grant access for the audits and for the contractor work through their landlords. Participant Responsibilities: Application submittal signifies commitment to full program participation. Participants must attend mandatory Green Blocks Pilot Project orientation session. Participants must be present at the time of the pre-scheduled energy audit and follow-up inspection of any work performed. Participants must respond to pre- and post-program survey. Participants must be willing to participate in publicity; special circumstances will be considered. This application and accompanying forms can be found at our Web site, ci.missoula.mt.us\greenblocks or by visiting the Mayor’s Office at 435 Ryman St. If you have questions, please visit our Web site or contact Chase Jones, Grants Administrator, at 258.4908. Please read the attached forms for more information: Included & Excluded Conservation Measures; Letter from the Mayor. ---PAGE BREAK--- Household Application 3 Green Blocks Pilot Project Giving Conservation a Square Deal Household Application Click on the gray fields to type your answers or print this form and clearly print your answers. (Please note that all forms are available online at ci.missoula.mt.us\greenblocks or can be picked up in the Mayor’s Office at 435 Ryman St.) Return this application to your two-block area Block Captain. NWE ACCOUNT HOLDER NAME Last First NWE SERVICE ADDRESS Street Missoula, MT City State Zip Code TELEPHONE NUMBERS Home Other (specify) E-MAIL ADDRESS NorthWestern Energy Account Number: Is this residence a: Single-family Home Multifamily Home (For multifamily homes there should be one applicant for each address.) Other (please specify) Do you: Rent Own ---PAGE BREAK--- Household Application 4 Home Heating Fuel Type (please check all that apply): Natural gas supplied by NorthWestern Energy Electricity supplied by NorthWestern Energy Wood Other (please list) Water Heating Fuel Type (please check all that apply): Natural gas supplied by NorthWestern Energy Electricity supplied by NorthWestern Energy Other (please list) When was your home built? 1920 or earlier 1920-1940 1940-1960 1960-1980 1980-1990 Have any improvements been made to the house to make it more energy efficient? No Yes—if you checked Yes, what improvements have been made? (Please list.) Agreements: Please check this box if you are willing to participate in an energy audit. Please check if you are willing to participate in pre and post surveys. Please check if you are willing to participate in publicity. (All information and data gathered from households will not be identified by name except with permission.) Please check if you are willing to participate in a Green Blocks orientation session. Please check this box to indicate that you will provide permission as required in advance of any work performed. Your Signature Date Printed Name Please return this completed application and accompanying forms to your Block Captain.