Mitigation Application Ranking System

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NOTICE OF INTENT – PRE-APPLICATION ELIGIBILITY AND SCORING WORKSHEET
FOR THE FEMA HAZARD MITIGATION GRANT PROGRAM - FEMA-4229-DR-CO
MITIGATION
5% PROJECT PROPOSALS
Some mitigation activities are difficult to evaluate using FEMA-approved cost-effectiveness methodologies. Up to 5 percent of the
total HMGP funds may be set aside by the Grantee to pay for such activities. These funds are not eligible to be used in situations
where the mitigation activities can be evaluated under FEMA-approved cost-effectiveness methodologies but do not meet the
required BCA threshold. Review HMA Guidance pages 84 and 85 for details.
Applicant/Organization:
Applicant Type:
Proposed Activity Title: _______________________________________________
State Agency
Tribal Government
Local Government
Private Non-Profit Organization
Primary Contact: _____________________________________ Primary Contact Title: ________________________________________________
Address: ____________________________________________ City: _____________________ County: ________________ Zip: ____________
Phone #: ____________________________________________ FAX # ____________________________________________________________
Email Address: __________________________________________________________________________________________________________
Alternate Contact: _____________________________________
Alternate Contact Title: ___________________________________________
Phone #: _____________________________________________
Email Address: __________________________________________________
If a Tribal or local government is the proposed applicant, does the Tribal or local government have a current FEMA approved, locally adopted multihazard mitigation plan OR if a state agency or private nonprofit organization is the proposed applicant, is the proposed project located totally within a
jurisdiction with a FEMA approved, locally adopted hazard mitigation plan?
No
Yes If unsure, please check with the County or City
Emergency Manager. If yes, name of plan: ___________________________________________________________________________________
If no, is the local jurisdiction developing or updating a local hazard mitigation plan?
Yes
No
Not Applicable
Proposed Project:
The use, evaluation, and application of new, unproven mitigation techniques, technologies, methods, procedures, or products
Equipment and systems for the purpose of warning citizens of impending hazards
Hazard identification or mapping and related equipment for the implementation of mitigation activities
GIS software, hardware, and data acquisition whose primary aim is mitigation
Public awareness or education campaigns about mitigation
Evaluation of model building codes in support of future adoption and/or implementation
Other (please specify) _______________________________________________________________________________________________
Is this project part of a larger project or larger effort?
Hazard(s):
Yes
No
Avalanche
Debris Flow
Drought
Earthquake
Erosion
Expansive Soils
Flood
Landslide
Lightning
Rock Fall
Subsidence
Tornado
Wildfire
Winter Weather
Other: ______________
Brief Description of the Proposed Project:
________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Location of project or recipients: ____________________________________________________________________________________________
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Describe the population directly benefitting from the proposed activity. Include quantities in the description and how they benefit:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Estimated Total Cost: _______________________ Federal Share: _________________________ Non-Federal Share: ______________________
Proposed Sources of funds for the Non-Federal Share: ____________________________________________________________________________
Please return completed NOI to Scott Baldwin (scott.baldwin@state.co.us) and Sean Settle (sean.settle@state.co.us)
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