State of California – Natural Resources Agency
DEPARTMENT OF PARKS AND RECREATION
DIVISION OF BOATING AND WATERWAYS (DBW)
BOATING FACILITIES DEVELOPMENT AND FINANCING PROGRAMS
APPLICATION FOR BOAT LAUNCHING FACILITIES (BLF) GRANT FUNDING Prior to completing and submitting this application, please contact DBW at (916) 327-1816. This form must be filled out and submitted to DBW no later than February 1st. Additional information/instructions and a fillable version of this form can be obtained from the DBW website at www.dbw.parks.ca.gov. Use a separate application for each requested grant.
USE ADDITIONAL SHEETS AS NECESSARY IN COMPLETING THIS APPLICATION. CROSS- REFERENCE EACH ADDITIONAL SHEET TO THE ITEM NUMBER BELOW.
For DBW Use Only: Assigned to:
1. DATE SUBMITTED: 2. RECEIVED BY DBW: APPLICATION NUMBER:
APPLICANT INFORMATION
3. LEGAL NAME OF APPLICANT: 4. TYPE OF APPLICANT:
City County
Special District Federal Government
Other Public Agency (specify):
5. MAILING ADDRESS OF APPLICANT: 6.
Name:
CONTACT INFORMATION:
Title:
Address (if different):
Telephone:
E-mail:
GENERAL PROJECT INFORMATION
7. NAME OF PROJECT:
8. PROJECT LOCATION AND BODY OF WATER PROJECT IS LOCATED ON: (Attach a site map)
9. HAS A DBW REPRESENTATIVE VISITED THE PROPOSED PROJECT SITE? Yes No (If yes, who and when?)
10. PROPOSED PROJECT COMPONENTS: (Check all that apply.) BOAT LAUNCHING FACILITY:
Ramp # of Existing Boat Ramp Lanes # of Proposed Single ADA Vehicle Stalls Boarding Floats # of Proposed Boat Ramp Lanes ADA Path of Travel Fish Cleaning Station # of Existing Vehicle/Trailer Stalls Solar Panels Electrical # of Proposed Vehicle/Trailer Stalls Wind Turbines Slope Protection # of Existing ADA Vehicle/Trailer Stalls Charging Stations (Electric Vehicles) Restrooms # of Proposed ADA Vehicle/Trailer Stalls Boat Hoists Pay Station # of Existing Single Vehicle Stalls Dump Stations Project Credit Sign # of Proposed Single Vehicle Stalls Gangways # of Existing Single ADA Vehicle Stalls
DPR 424 (Rev. 1/2016)(Word 1/25/2016)(Page 1 of 7)
11. (a) HAS A PUBLIC HEARING CONSISTENT WITH FEDERAL LAW OR REGULATION TAKEN PLACE REGARDING THE PROPOSED PROJECT? Yes No
(If yes, when and where?)
(b) IS THERE PUBLIC SUPPORT OR OPPOSITION FOR THE PROPOSED PROJECT? Yes No (Please describe)
12. DESCRIBE THE PROBLEM THE PROPOSED PROJECT WILL SOLVE. FOR EXAMPLE, DOES THE PROJECT FIX OR ADDRESS A HEALTH, ACCESS, OR SAFETY ISSUE FOR USERS AT THE FACILITY?
13. DESCRIBE THE SCOPE OF THE PROJECT TO BE FINANCED WITH DBW FUNDING:
14. DESCRIBE THE TYPES OF BOATING DONE AT THE PROPOSED FACILITY/IMPROVEMENTS:
15. WHAT ARE THE PROPOSED EXISTING HOURS OF FACILITY OPERATION?
16. DESCRIBE THE IMPORTANCE OR SIGNIFICANCE OF THE PROPOSED PROJECT:
DPR 424 (Page 2 of 7)
17. HAS LOCAL LAW ENFORCEMENT (SHERIFF/MARINE PATROL) BEEN CONSULTED TO ENSURE THE PROPOSED FACILITY MEETS THE NEEDS FOR WATER RESCUE? Yes No (If yes, provide the date and identify the components added to satisfy law enforcement needs. If no, explain)
18. (a) ARE THERE ANY IMPEDIMENTS TO ACCESSING THE FACILITY (i.e. SECURITY GATES):
(b) WHAT IS THE PROCESS FOR FACILITY ADMITTANCE?
19. (a) DOES THE EXISTING FACILITY MEET CURRENT AMERICANS WITH DISABILITIES ACT (ADA) CODE REQUIREMENTS? Yes No
(If no, identify needed improvements)
(b) DOES THE PROPOSED PROJECT IMPROVEMENTS HELP THE SITE MEET CURRENT REQUIRED ADA REQUIREMENTS? Yes No
(If yes, how)
(c) HAS AN ADA EXPERT BEEN CONSULTED TO ENSURE THE PROPOSED PROJECT COMPLIES WITH ADA REQUIREMENTS? Yes No
(If yes, provide details)
20. (a) WILL THE PROJECT BE OPEN AND ACCESSIBLE TO ALL PUBLIC RECREATIONAL BOATERS? (b) DOES THE PROJECT IMPROVE EXISTING OR CREATE NEW PUBLIC ACCESS AT THIS FACILITY? (c) DOES THE PROJECT PROVIDE ACCESS TO UNIQUE BOATING OPPORTINUTIES? DPR 424 (Page 3 of 7)
21. (a) INDICATE BELOW THE FEES A PERSON MUST PAY TO LAUNCH A BOAT:
Launching $
Parking $
Facility Entrance $
Invasive Species Inspection $
Other: $
Other Fee Explanation:
(b) WHAT IS THE ANNUAL NUMBER OF BOAT LAUNCHES AT THE EXISTING FACILITY? Total: Motorized: Non_motorized:
(c) WHAT IS THE PROJECTED ANNUAL NUMBER OF BOAT LAUNCHES AT THE IMPROVED FACILITY? Total: Motorized: Non_motorized:
(d) WHAT WAS THE METHODOLOGY USED TO ARRIVED AT THIS NUMBER?
22. LIST ALL PERMITS AND APPROVALS REQUIRED TO CONSTRUCT THE PROJECT:
(A Notice of Exemption from CEQA is NOT an exemption from other regulatory agencies)
23. STATUS OF PERMITS:
A. Permit:
Not started
In progress (Attach copy of app)
Date of consideration
Expected completion
Approved (Attach copy)
B. Permit:
Not started
In progress (Attach copy of app)
Date of consideration
Expected completion
Approved (Attach copy)
C. Permit:
Not started
In progress (Attach copy of app)
Date of consideration
Expected completion
Approved (Attach copy)
DPR 424 (Page 4 of 7)
SPECIFIC PROJECT INFORMATION
24. REQUESTED FUNDING
AMOUNT:
$
25. ESTIMATED PROJECT
TIMELINE:
Start Date:
Completion Date:
Attach schedule, see instructions
26. PROJECT
New
Previous Year (s) of DBW
funding* *Attach description of year and purpose
of funding
27. ESTIMATED PROJECT COSTS:
Cost Category Amount
a. Construction $
b. Engineering (12%)* $
c. Escalation (10%)* $
d. Contingency (10%)* $
e. Inspection (5%)* $
f. Permits (3%)* $
g. TOTAL $
Attach itemization of costs that have been expensed on a separate sheet. *(% of construction sub-total)
28. STATUS OF OTHER PROJECT FUNDING SOURCES:
(Attach copy of any funding applications, or approved letters of intent to fund.) Name of Funding Source Amount
a. DBW: $
b. APPLICANT: $
c. CITY/COUNTY: $
d. OTHER STATE SOURCES: $
e. FEDERAL: $
f. OTHER (specify): $
g. TOTAL: $
TOTALS in Sections 27 and 28 must be equal.
Status of Funding
Applied For Approved
Yes No Yes No
Yes No Yes No
Yes No Yes No
Yes No Yes No
Yes No Yes No
Yes No Yes No
29. STATUS OF PROJECT PLANNING: 30. ENVIRONMENTAL IMPACT (NEPA/CEQA) Completed
Technical Feasibility Study Yes No
Preliminary Design Yes No
Engineer’s Cost Estimate Yes No
Final Design Yes No
Status of NEPA/CEQA Compliance:
Not Started, Expected Completion Date:
In Progress, Expected Completion Date:
Adopted/Approved (Attach copy of app or approval)
Expected/Determined Level of CEQA Clearance:
Notice of Exemption
Negative Declaration
Environmental Impact Report (EIR)
Unknown
DPR 424 (Page 5 of 7)
PUBLIC BENEFIT AND ECONOMIC DEVELOPMENT INFORMATION
31. (a) WHAT ARE THE PUBLIC BENEFITS OF THE PROJECT?
(b) WHAT ARE PROJECTED ECONOMIC DEVELOPMENT BENEFITS TO THE SURROUNDING MINICIPALITIES OF THE PROPOSED PROJECT?
(c) IS THE PROJECT A PART OF A LARGER COMMUNITY DEVELOPMENT PLAN OR STRATEGY? Yes No, If “Yes”, please explain and provide a copy of the supporting development plan or master plan.
32. IS THERE A DEMONSTRATED DEMAND FOR A BOAT LAUNCHING FACILITY AND ACCESS AT THE PROJECT LOCATION? Yes No, (If yes, explain)
33. (a) IS THE EXISTING FACILITY IN AN UNDERSERVED AREA? Yes No (If yes, explain)
(b) WILL THE PROPOSED PROJECT INCREASE ACCESS OR USAGE BY AN UNDERSERVED PUBLIC? Yes No (If yes, explain)
(c) WILL THE PROPOSED PROJECT PROVIDE ECONOMIC BENEFIT TO THE LOCAL AREA? Yes No (If yes, how)
(d) WILL THE PROPOSED PROJECT INCREASE SERVICE TO BOATERS OUTSIDE THE LOCAL AREA (PROMOTE TOURISM)?
Yes No (If yes, how)
DPR 424 (Page 6 of 7)
OTHER INFORMATION
34. (a) DOES APPLICANT OWN THE PROJECT SITE?
(b) DOES APPLICANT HOLD A LONG-TERM LEASE AGREEMENT ON THE PROJECT SITE? IF SO, WHEN DOES IT EXPIRE?
(c) DOES APPLICANT OPERATE THE SITE THROUGH A CONCESSIONAIRE? IF SO, WHEN DOES THE CONCESSIONAIRE AGREEMENT EXPIRE?
(d) APPLICANT MUST OWN OR CONTROL THE PROJECT AREA AND RIGHTS OF WAY TO AND FROM THE PROJECT AREA. APPLICANT SHALL MAINTAIN THE PROJECT AREA AND ALL IMPROVEMENTS FUNDED
BY THE GRANT IN ACCORDANCE WITH DBW MAINTENANCE GUIDELINES FOR THE LIFE OF THE GRANT (20 YRS).
(Provide copies of any related lease agreements, etc. concerning the control and operation of the project site.)
35. PROVIDE A RESOLUTION FROM THE GOVERNING BODY AUTHORIZING APPLICANT TO APPLY FOR FUNDING. (sample enclosed)
36. ATTACH COPIES OF ANY INITIAL DRAWINGS OR DESIGNS.
37. IF THE APPLICANT HAS RETAINED AN OUTSIDE ENGINEER, DESIGN OR OTHER CONSULTANT FOR THE PROJECT, PLEASE PROVIDE THE CONTACT INFORMATION.
Name:
Title:
Company:
Address:
Telephone:
E-mail:
Name:
Title:
Company:
Address:
Telephone:
E-mail:
APPLICANT ACKNOWLEDGEMENT AND SIGNATURE
Under penalty of perjury, I hereby certify that I am an authorized representative of the Applicant, and that I have been authorized by the Applicant by resolution to execute this Application for DBW funding.
AUTHORIZED SIGNATURE: PRINT NAME AND TITLE: DATE:
DPR 424 (Page 7 of 7)
DIVISION OF BOATING AND WATERWAYS
BOATING FACILITIES DEVELOPMENT AND FINANCING PROGRAMS
APPLICATION INSTRUCTIONS
USE ADDITIONAL SHEETS AS NECESSARY. CROSS-REFERENCE EACH ADDITIONAL SHEET TO THE RESPECTIVE ITEM NUMBER ABOVE.
Download th e electronic version of the Application,
available a t www.dbw.parks.ca.gov. Insert data into
the shaded areas. Use your T ab k ey to g o from o ne
shaded area to the next. Us e additional s heets if
necessary.
1. Enter today’s date.
2. For DBW use only.
APPLICANT INFORMATION
3. Provide full, legal name of Applicant.
4. Check appropriate box.
5. Provide mailing address.
6. Provide contact information.
GENERAL PROJECT INFORMATION
7. Provide full, legal name of project.
8. Provide the Project lo cation information, address, and name of body of water project is located on. Attach a site map of the Project on a separate piece of paper.
9. Provide the name of the DBW representatives.
10. Check all that apply.
11. Provide public hearing, support, and opposition
information.
12. Describe issues and problems the project will solve.
12. Describe the project.
13. Describe the project.
14. Describe types of boating.
15. Describe the hours of facility operation.
16. Describe the project’s significance.
17. Identify law enforcement needs.
18. Describe any impediments and process to access the
Facility.
19. Provide ADA information.
20. Describe the project’s accessibility.
21. Provide fees, annual boat launches, and
projected annual boat launches.
22. Identify and provide status of obtaining each
required permit.
23. Fill in as directed and check appropriate box.
SPECIFIC PROJECT INFORMATION
24. Total amount of funds requesting.
25. Attach schedule showing dates of project planning,
design, construction, and completion.
26. Are the funds requested new, or a continuation of a previous project? Attach a description of the purpose of prior funding.
27. Estimated proje ct co st. The % is based on c onstruction sub-total.
28. Estimate the project funding sources and amounts.
Fill in the name of any other funding sources and
Whether funds have been applied for and/or are
approved.
29. Check appropriate box.
30. Check appropriate box and fill in as directed.
PUBLIC BENEFIT AND ECONOMIC
DEVELOPMENT INFORMATION
31. Describe the public benefits of the proposed Project, including how the Project promotes economic development
32. Will the project develop and enhance public infrastructure in a manner that will attract, create and sustain recreational boating and other amenities in the community and will
enhance the quality of life and community amenities for area residents, and any other public benefits?
33. Describe how the project will increase access or usage to the underserved area, provide economic benefit to the local area, and increase service to boaters outside the local area.
OTHER INFORMATION
34. Self-explanatory.
35. Self-explanatory.
36. Self-explanatory.
37. Self-explanatory.
APPLICANT ACKNOWLEDGEMENT AND SIGNATURE
To be signed by the authorized representative of the Applicant per resolution.
*Cross-reference any attached documents to its
corresponding item number in the application*
MAIL COMPLETED APPLICATION TO:
Division of Boating and Waterways
Boating Facilities Development and Financing Program
Attn: Keren Dill, Chief
One Capitol Mall, Suite 500
Sacramento, California 95814
DPR 424 (INSTRUCTIONS)