Virginia Department of Emergency Management Project Grant Application
Section I. Applicant Information 1. Application Title: 2. Name of Applicant: 3. Type of Applicant: Select One... If Other, please specify: 4. Is this a Small, Impoverished Community? Select One... 5. Federal Tax Number: 6. State Tax Number: 7. Federal Employer Identification Number or Tribal Identification Number: 8. DUNS Number: 9. County(ies): 10. Congressional Districts: 11. State Legislative Districts: House: Senate: 12. FIPS Code: CID Number: 13. Point of Contact Select First Name: Last Name: Title: Agency/Organization: Address: City: State: Zip+4: Phone: Fax: Email: 14. Alternate Point of Contact Select First Name: Last Name: Title: Agency/Organization: Address: City: State: Zip+4: Phone: Fax: Email: 15. Designated Agent Select First Name: Last Name: Title: Agency/Organization: Address: City: State: Zip+4: Phone: Fax: Email: Virginia Department of Emergency Management Project Grant Application
Section II. Mitigation Plan Information 1. Is the entity that will benefit from the proposed activity covered by a current FEMA- approved multihazard mitigation plan in compliance with the Disaster Mitigation Act of 2000? Select One... a. If Yes, provide the FEMA approval date: b. If No, has the plan been submitted for review? Select One... c. If the plan has been submitted for review, which agency is currently reviewing the plan? Select One... d. Please provide the date the plan was submitted for review: 2. What is the name of the plan? 3. What is the type of plan? 4. Do you have other mitigation plans that have been adopted by your community? Select One... 5. If Yes, provide the plan name and plan type of each additional mitigation plan adopted by your community. 6. Please identify all previous FEMA planning grants received: 7. Additional comments:
Section III. Mitigation Activity Information 1. What type of activity are you proposing? Please select one of the following options to describe the intent of this proposal: Develop a new plan Comprehensive review and update an existing Disaster Mitigation Act of 2000 plan Upgrade an existing plan adopted prior to the Disaster Mitigation Act of 2000 2. Title of your proposed activity (should include the location and type of activity).
Section IV. Problem Description 1. Please describe the problem to be mitigated. Include the geographic area in your description.
Section V. Location Information 1. Describe the geographical area(s) to be covered by the plan. Attach geographical/topographical maps. Virginia Department of Emergency Management Project Grant Application
Section VI. Hazard Information 1. Identify the source(s) of hazards specific to the geographic area to be addressed in the plan.
Section VII. Scope of Work 1. Explain how the project solves the problem. 2. Project Milestones: Enter the steps to be taken, the tasks to be completed over the life of the project, and the timeframe for completing each task. Task Starting Point Unit of Time Duration Work Complete By
3. Enter total project duration. 4. Additional Comments:
Section VIII. Cost Estimate In this section, provide the details of all costs associated with this project.
Item Name Unit Quantity Unit of Measure Unit Cost Total Item Cost
Total Project Cost: Virginia Department of Emergency Management Project Grant Application
Section IX. Match Sources 1. Indicate Federal and Non-Federal Shares of Total Project Cost a. Total Project Cost: b. Federal Share: Indicate Percentage: c. Non-Federal Share: Indicate Percentage: 2. Indicate Non-Federal Source #1 a. Non-Federal Funding Source: Select One... b. Name of Funding Source: c. Funding Type: Select One... d. Amount of Matching Funds: 3. Indicate Non-Federal Source #2 (if applicable) a. Non-Federal Funding Source: Select One... b. Name of Funding Source: c. Funding Type: Select One... d. Amount of Matching Funds: 4. Indicate Non-Federal Source #3 (if applicable) a. Non-Federal Funding Source: Select One... b. Name of Funding Source: c. Funding Type: Select One... d. Amount of Matching Funds: Virginia Department of Emergency Management Project Grant Application
Section X. Evaluation Information (Part 1 of 4) 1. If applying for multiple mitigation activities, how do these activities relate (i.e., mitigation project as demonstration for public education; two different mitigation activities for the same structure; feasibility study and related mitigation activity)? NOTE: Mitigation activities included in a given application must be related. 2. Is your community a participant in the National Flood Insurance Program (NFIP)? Select One... 3. Is your community participating in the Community Rating System (CRS)? Select One... If yes, what is your CRS rating? 4. Is your community a Cooperating Technical Partner (CTP)? Select One... 5. Is your community a Firewise Community? Select One... If yes, please provide Firewise Community number. 6. Has your community adopted building codes consistent with the International Codes? Select One... 7. Has your community adopted the National Fire Protection Association (NFPA) 5000 Code? Select One... 8. Have your community's building codes been assessed on the Building Code Effectiveness Grading Schedule (BCEGS)? Select One... If yes, what is your BCEGS rating? 9. Describe the desired outcome and methodology of the mitigation activity in terms of mitigation objectives to be achieved. 10. Describe performance expectations and timeline for interim milestones and overall completion of mitigation activity. 11. Describe the staff and resources needed to implement this mitigation activity and applicant's ability to provide these resources. 12. Describe how this mitigation activity will incorporate State, Tribal, private, or local community involvement to enhance its outcome through partnership. 13. Describe how your community uses incentives to encourage mitigation (e.g., tax credits, building codes, waiver of building permit fee, FEMA-approved mitigation plan in place).
14. Describe any outreach activities that are planned relative to this mitigation activity (e.g., signs, press releases, success stories, developing package to share with other communities, losses avoided analysis). 15. Describe how this mitigation activity is creative and innovative. 16. Describe how this mitigation activity will serve as a model for other communities (i.e., Do you intend to mentor other communities, Tribes or States? Do you intend to prepare a description of the process followed in this activity so that others may learn from the example?). 17. Please provide the percent of the population benefiting from this mitigation activity. (The percent of the population benefiting is calculated by dividing the count of individuals directly benefiting into the total population of the community(s) this project affects.) Please explain your response. 18. Describe how this mitigation activity supports National Priorities, complies with Federal laws and Executive Orders (National Environmental/Historic Preservation Policy Act, National Virginia Department of Emergency Management Project Grant Application
Historic Preservation Act, Endangered Species Act, Clean Water Act, Executive Order 11988, Floodplain Management, Executive Order 11990, Protection Of Wetlands, Executive Order 12699, Seismic Safety of Federal and Federally Assisted or Regulated New Building Construction) and is complementary to other Federal programs (American Heritage Rivers Initiative; SBA Mitigation Loan Program; EPA Watershed Initiative, US Fish and Wildlife Services Fish Passage Program) 19. Describe how this mitigation activity offers long-term financial and social benefits.
Evaluation Information (Part 2 of 4) 1. Describe how this planning activity will benefit your constituents. 2. Describe the strategy for completing this planning activity, including the review process, adoption, and FEMA’s approval. 3. Describe how you will manage the costs and schedule, and how will you ensure successful performance. 4. Describe the staff and resources needed to implement this mitigation activity and the applicant’s ability to provide these resources. 5. If applying for multiple mitigation activities, how do these activities relate?
Evaluation Information (Part 3 of 4) 1. How will this mitigation activity leverage involvement of partners to enhance its outcome.
2. What outreach activities are planned relative to this mitigation activity (e.g. signs, press releases, success stories, developing package to share with other communities, losses avoided analysis) and/or how will this mitigation activity serve as a model for other communities (i.e. Do you intend to mentor other communities, Tribes, or States? Do you intend to prepare a description of the process followed in this activity so that others may learn from the example?)?
Virginia Department of Emergency Management Project Grant Application
Evaluation Information (Part 4 of 4) 1. Please provide an assessment of the frequency (high, moderate, low, very low, not applicable) and severity (catastrophic, extensive, serious, minor, not applicable) of an event for each of the following hazards: Coastal Storms Severe Ice Storms High Catastrophic High Catastrophic Moderate Extensive Moderate Extensive Low Serious Low Serious Very Low Minor Very Low Minor Not Applicable Not Applicable Not Applicable Not Applicable Earthquake Sever Storms High Catastrophic High Catastrophic Moderate Extensive Moderate Extensive Low Serious Low Serious Very Low Minor Very Low Minor Not Applicable Not Applicable Not Applicable Not Applicable Windstorms Snow High Catastrophic High Catastrophic Moderate Extensive Moderate Extensive Low Serious Low Serious Very Low Minor Very Low Minor Not Applicable Not Applicable Not Applicable Not Applicable Fire Tornado High Catastrophic High Catastrophic Moderate Extensive Moderate Extensive Low Serious Low Serious Very Low Minor Very Low Minor Not Applicable Not Applicable Not Applicable Not Applicable Flood Tsunami High Catastrophic High Catastrophic Moderate Extensive Moderate Extensive Low Serious Low Serious Very Low Minor Very Low Minor Not Applicable Not Applicable Not Applicable Not Applicable Virginia Department of Emergency Management Project Grant Application
Freezing Typhoon High Catastrophic High Catastrophic Moderate Extensive Moderate Extensive Low Serious Low Serious Very Low Minor Very Low Minor Not Applicable Not Applicable Not Applicable Not Applicable Hurricane Volcano High Catastrophic High Catastrophic Moderate Extensive Moderate Extensive Low Serious Low Serious Very Low Minor Very Low Minor Not Applicable Not Applicable Not Applicable Not Applicable Mud/landslide High Catastrophic Moderate Extensive Low Serious Very Low Minor Not Applicable Not Applicable