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Prairie Fen and Associated Savanna Restoration Submittal Package

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Prairie Fen and Associated Savanna Restoration Submittal Package Region 3 Wildlife and Sport Fish Restoration Transmittal Form U.S. Fish and Wildlife Service WSFR Bishop Henry Whipple Federal Building One Federal Drive Fort Snelling, MN 55111-4056 Date Received: Date Approval Requested by: Friday, September 25, 2009 (Region 3 FA Date Stamp) Date Submitted: Thursday, August 27, 2009 Project No.: To Be Determined Project Title: Prairie Fen and Associated Savanna Restoration in Michigan and Indiana for Species of Greatest Conservation Need State Contact: Eric Sink FWS Biologist: Mike Sweet, (612) 713-5129 Telephone Number: (517) 335-1064 e-mail address: [email protected] Track (check one): Routine = 15 day Non-Routine = 30 day Non-Routine = 45 day Type(s): Grant Proposal (GP): GP Renewal: Grant Segment: GP Amend: Segment Amend: USFWS will complete USFWS will complete Obligation Intent: Sub-Account Federal Share Circle or Check if Applicable: WR Regular 5220 $ In-Kind Value Program Income WR Sect 4 Hunter Ed 5210 $ SHPO WR Sect 10 Hunter Ed 523 $ NEPA (EA Letter or EA) Section 7 WL Cons. & Rest. 5511 $ Lobby Certification SFR Regular 9514 $ Other (describe in Note/Special Instructions section below) SFR Aquatic Ed. 9511 $ Needs funding condition (describe in Note/Special Instructions section below) SFR Boat Access 9521 $ COMPETITIVE ( ) or NON-COMPETITIVE ( ) Other : $ 864,020 Competitive SWG Notes/Special Instructions (check): Biologist Fiscal Land Secretary Mike, until we can get the Section 7 consultation and biological opinion documents, can you approve with the caveate that no work is to be done in any occupied habitat until documentation is provided. Chris, please obligate entire amount. WILDLIFE AND SPORT FISH RESTORATION State: Michigan CHECKLIST Project #: TBD Proposed start: 9/15/2009 End date: 9/30/2011 Project Title: Prairie Fen and Associated Savanna Restoration in Michigan and Indiana for Species of Greatest Conservation Need Key: X = Document Received or Requirement Met NA = Not Applicable 1,2,3,4, = See Notes Section Standard Forms1 X Application for Federal Assistance (Standard Form 424) Narratives2 X Grant Proposal – See Project Statement Information below X Annual Work Plan with Budget Other Materials X Transmittal form X Lobbying Certificate X NEPA documentation, or letter, or explained in narrative X Phase I Section 7 Evaluation Form Other Information as Relevant NA State Clearinghouse/Single Point of Contact Letter3 NA Section 106 National Historic Preservation Act Compliance: NA Clearance from State Historic Preservation Officer NA Clearance from Tribal Historic Preservation Officer/Contacts NA Environmental Assessment (EA) or Environmental Impact Statement (EIS) NA Program Income - Amount projected and intention of how it will be used and credited NA In-kind match - Source, type, and amount NA Engineering plans, and specifications4 NA Army Corp of Engineering Permit NA Documentation of land control for facilities construction grants and habitat development grants. 1Originals and 2 copies of each form, signed by an authorized State official. 2All documentation follows FA Handbook, 43 CFR Part 12, Program Rule (e.g. 50 CFR 80) 3States exempted are MN (all Federal Aid, January 3, 1984), MO (PR and DJ research, plus Section 6 ESA only June 29, 1987), IA (Section 6 only July 26, 1991), IN (all Federal Aid, March 21, 1990), MI (PR and DJ, Section 6, Natl. Coastal Wetlands, Anadromous Fish, August 24, 1995), OH (Clearinghouse closed 3/10/97), all states for State Wildlife Grants 4Required only when requested by Federal Aid Division. See 522 FW 10.5D and 50 CFR 80.11(a). Submission of preliminary documents will facilitate approval of Grant Agreement. Project Statement Information (refer to www.fws.gov/r3pao/fed_aid/programs/guidelines.htm for guidance) X Needs X Objectives X Expected results and benefits X Approach X Specific procedures to be employed X Schedules or target dates X Locations X Key project personnel and cooperators X List of work items X Cost estimates by year X Compliance (NEPA, ES, NHPA, Floodplains E.O. 11988, Wetlands E.O. 11990, ADA, Relocation, use of chemicals) FOR REGIONAL OFFICE USE ONLY ___ Triage review of grant package completed ___ Lands documentation (refer to Lands Guidelines) ___ Engineering Review Request - sent ___ NEPA Checklist signed by Region 3 biologist ___ Environmental Action Statement (EAS) ___ Finding Of No Significant Impact (FONSI) ___ Record of Decision (ROD) ___ Phase II Section 7 Evaluation Form ___ For SWG – relationship to State CWCS adequately identified ___ Conditional Statement(s) ___ All document approval information entered into FAIMS Notes Completed by: Signature Date: APPLICATION FOR Version 7/03 FEDERAL ASSISTANCE 2. DATE SUBMITTED August 27, 2009 Applicant Identifier 1. TYPE OF SUBMISSION: 3. DATE RECEIVED BY STATE State Application Identifier Application : Pre-application Michigan Construction Construction 4. DATE RECEIVED BY FEDERAL AGENCY Federal Identifier Non-Construction Non-Construction TBD Including Segment 1 5. APPLICANT INFORMATION Legal Name: MICHIGAN DEPARTMENT OF NATURAL RESOURCES Organizational Unit: Department: Michigan Department of Natural Resources Organizational DUNS: 805339991 Division: Wildlife Address: Name and telephone number of person to be contacted on matters involving this Street: PO BOX 30028 application (give area code) Prefix: Mr. First Name: Eric City: LANSING Middle Name: County: INGHAM Last Name: Sink State: MI Zip Code: 48909-7528 Suffix: Country: USA Email: [email protected] 6. EMPLOYER IDENTIFICATION NUMBER (EIN): Phone Number (give area code) Fax Number (give area code) 38-6000134 (517) 335-1064 (517) 373-1547 8. TYPE OF APPLICATION: 7. TYPE OF APPLICANT: (See back of form for Application Types) New If Revision, enter appropriate letter(s) in box(es) A. State Government (See back of form for description of letters.) Other (specify): None None Other (specify): 9. NAME OF FEDERAL AGENCY: U.S. DOI - Fish & Wildlife Service 10. CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 11. DESCRIPTIVE TITLE OF APPLICANT’S PROJECT: 15.634 - State Wildlife Grants Prairie Fen and Associated Savanna Restoration in Michigan and Indiana for Species of Other (specify): Greatest Conservation Need 12. AREAS AFFECTED BY PROJECT (Cities, Counties, States, etc.): Southern Michigan and Northern Indiana 13. PROPOSED PROJECT 14. CONGRESSIONAL DISTRICTS OF: Start Date: 09/15/2009 Ending Date: 09/30/2011 a. Applicant: Eighth b. Project: Various 15. ESTIMATED FUNDING: 16. IS APPLICATION SUBJECT TO REVIEW BY STATE EXECUTIVE ORDER 12372 PROCESS? a. Federal $ 864,020 a. YES THIS PREAPPLICATION/APPLICATION WAS MADE AVAILABLE TO THE STATE EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON b. Applicant $ 0 c. State $ 320,000 DATE: August 27, 2009 d. Local $ 0 b. NO PROGRAM IS NOT COVERED BY E. O. 12372 e. Other $ 280,421 OR PROGRAM HAS NOT BEEN SELECTED BY STATE FOR REVIEW f. Program Income $ 0 17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT? g. TOTAL $ 1,464,441 Yes If “Yes” attach an explanation. No 18. TO THE BEST OF MY KNOWLEDGE AND BELIEF, ALL DATA IN THIS APPLICATION/PREAPPLICATION ARE TRUE AND CORRECT. THE DOCUMENT HAS BEEN DULY AUTHORIZED BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES. a. Authorized Representative Prefix: Ms. First Name: Mindy Middle Name: S. Last Name: Koch Suffix: b. Title: c. Telephone Number (give area code) Resource Management Deputy (517) 373-0046 Email: Fax Number (give area code) (517) 373-1164 d. Signature of Authorized Representative e. Date Signed: August 27, 2009 Previous Edition Usable Standard Form 424 (Rev. 9-2003) Authorized for Local Reproduction Prescribed by OMB Circular A-102 BUDGET INFORMATION - Non-Construction Programs OMB Approval No. 3048-0044 SECTION A - BUDGET SUMMARY Grant Program Catalog of Federal Estimated Unobligated Funds New or Revised Budget Function Domestic Assistance or Activity Number Federal Non-Federal Federal Non-Federal Total (a) (b) (c) (d) (e) (f) (g) 1. Competitive SWG 15.634 $0 $0 $864,020 $600,421 $1,464,441 2. $0 3. $0 4. $0 5. Totals $0 $0 $864,020 $600,421 $1,464,441 SECTION B - BUDGET CATEGORIES GRANT SEGMENT BUDGET DETAILS Total 6. Object Class Categories (Segment 1) (Segment 2) (Segment 3) (Segment 4) (5) a. Personnel $148,121 $148,121 b. Fringe Benefits $56,286 $56,286 c. Travel $5,000 $5,000 d. Equipment $10,000 $10,000 e. Supplies $50,000 $50,000 f. Contractual $1,150,000 $1,150,000 g. Construction $0 $0 h. Other - Audit - 0.0038 $5,544 $5,544 i. Total Direct Charges (sum of 6a-6h) $1,424,950 $1,424,950 j. Indirect Charges - 0.1932 $39,491 $39,491 k. TOTALS (sum of 6i-6j) $1,464,441 $1,464,441 7. Program Income $0 $0 $0 $0 $0 Previous Edition Usable Authorized for Local Reproduction Standard Form 424A (Rev. 7-97) SECTION C - NON-FEDERAL RESOURCES (a) Grant Program (b) Applicant (c) State (d) Other Sources (e) TOTALS 8. Competitive SWG $320,000 $280,421 $600,421 9. $0 10. $0 11. $0 12. TOTAL (sum of lines 8-11) $0 $320,000 $280,421 $600,421 SECTION D - FORECASTED CASH NEEDS Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter 13. Federal $288,007 $72,002 $72,002 $72,002 $72,002 14. Non-Federal $200,140 $50,035 $50,035 $50,035 $50,035 15. TOTAL (sum of lines 13 and 14) $488,147 $122,037 $122,037 $122,037 $122,037 SECTION E - BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT FUTURE FUNDING PERIODS (Years) (a) Grant Program (b) First (c) Second (d) Third (e) Fourth 16. Competitive SWG $288,007 $288,007 $0 $0 17. 18. 19. 20. TOTAL (sum of lines 16-19) $288,007 $288,007 $0 $0 SECTION F - OTHER BUDGET INFORMATION 21. Direct Charges: 22. Indirect Charges: 19.32% on Personnel and Fringe Benefits 23. Remarks: Authorized for Local Reproduction Standard Form 424A (Rev.
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