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E. PROJECT LOCATION [TMK(s)] (See Instruction Sheet): <br />F. PROJECT COST (See Instruction Sheet): <br />Amount requested: $ 56,100.00 <br />Applicant share: $ 25,200.00 <br />Other resources: $ 0.00 <br />Total Project Cost: $ 81,300.00 <br />G. REQUIRED DOCUMENTS: <br />❑✓ Non-profit (501(c)(3), IRS letter of determination <br />❑✓ Copy of organization bylaws and mission statement <br />❑✓ DCCA Certificate of Vendor Compliance <br />❑✓ Letter of Authorized Signer for Organization <br />H. CERTIFICATION: <br />The applicant shall secure all necessary approvals and permits from the other <br />affected federal, state, and county agencies as necessary to comply with all <br />applicable laws and regulations. This may require appropriate permits from the <br />Department of Land and Natural Resources (DLNR) if parcels maybe within the <br />State Land Use Conservation District. The applicant certifies that the information <br />contained in this application is true and correct to the best of his/her knowledge. <br />Name of Authorized Official: Kulia Tolentino-Potter <br />Signed: lc� Date: 08/28/2022 <br />Title: President <br />Stewardship Grant Application, Page 2 of 7 <br />