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Page 1 of 2 Cost-Share Program Application Rev. April 2016 PUYALLUP’S RAIN GARDEN PROGRAM COST-SHARE PROGRAM APPLICATION Please complete this application and submit to: Joy Rodriguez, [EMAIL REDACTED], 333 S Meridian, Puyallup, WA 98371. Questions? Email or call: [PHONE REDACTED] APPLICANT INFORMATION Name: Street address: ZIP Code: Phone: Email: Parcel No.: Is your property within City of Puyallup limits: Yes No Owned Rented If rented, please provide landlord information Landlord: Phone: GREEN STORMWATER INFRASTRUCTURE INFORMATION What GSI are you interested in installing (check all that apply): Rain Garden Permeable Pavement Rain Barrel Do you have any GSI currently installed on your property: Yes No SIGNATURE Applicant Signature: Date: **TO BE COMPLETED BY PROGRAM STAFF** PRELIMINARY SITE EVALUATION Staff name: Date: Parcel address evaluated: Property within City of Puyallup limits: Yes No Potential location away foundation(s): Yes No N/A How far: ft Condition of existing GSI: Maintained In need of upkeep N/A Explain: PERCOLATION TEST Staff name: Date: Test location: (Attach sketch of property and identify test location and existing structures) PIT depth: in Water: in Time: start end Infiltration rate: PROGRAM DETERMINATION Applicant Approved: Yes No Rain Garden Permeable Pavement Rain Barrel Explain: Date ---PAGE BREAK--- Page 2 of 2 Cost-Share Program Application Rev. April 2016 Program Eligibility and Restrictions This is a cost-share program wherein the program participant pays a portion of the costs involved. For permeable pavements: the City will reimburse the participant 50% of the total cost, up to $7,500. For rain gardens, participants pay all labor costs and the City pays for material costs such as plants and soil, up to $1,000. For rain barrels: the City will reimburse the participant up to $125, not to exceed the price of the rain barrel. This program has limited funding and is available on a first-come first-served basis according to application date, and until funds run out. Preliminary site visits must be held and percolation tests completed within three weeks of application date. Applications will be approved/denied based on application content, site suitability, and program-fund availability. Once approved, installations must be completed within three months of approval date. Design and install location shall be reviewed by the CITY for conformity with design guidelines. Eligible GSI includes: rain gardens, permeable pavements, and rain barrels. PARTICIPANTS may install one each of the eligible GSI elements per the program restrictions. The program is not open to commercial properties. Rain garden designs and installations shall follow the Rain Garden Design Manual for Western Washington and permeable pavements shall follow the 2012 Low Impact Development Technical Guidance Manual for Western Washington. Design and location shall be reviewed by the City. Properties shall be located within City of Puyallup limits. The cost-share amounts for each the CITY and PARTICIPANT are typically not equal, and will depend on design, PARTICIPANT-selected CONTRACTOR, and other factors. Submittal of an application does not guarantee available funds or approval for program. Any work performed or costs incurred for rain gardens or permeable pavements prior to execution of a Cost-Share Agreement with the CITY will not be program eligible. Rain barrel purchases made prior to program approval may not be eligible for reimbursement. Permeable pavements shall be installed by a licensed contractor experienced in landscaping or pavement construction and pre-approved by the CITY. Permeable pavement installations are limited to replacement in-place of existing impervious pavements or when impervious pavements would otherwise be installed and in areas that are subject to stormwater runoff and not covered by a carport, awning, or other structure. Rain Gardens, up to and including grading of the rain garden to meet design plans, and installation of mulch layer shall be completed by a licensed contractor experienced in landscaping or construction projects and pre-approved by the CITY. Rain garden designs and installations shall follow the 2013 Rain Garden Design Manual for Western Washington. Rain barrels shall be a minimum of 40 gallons in size and pre-made. Materials for construction of a ‘homemade’ barrel do not qualify for reimbursement. Delivery and installation costs of the purchased rain barrel may be included in total allowed reimbursement amount. Total, combined CITY cost & reimbursement for all approved PARTICIPANT projects, including all selected and approved GSI elements, shall not exceed $8,725. Complete details are outlined in the Cost-Share Application, Cost-Share Agreement and Rain Barrel Reimbursement Form.