ࡱ > M O J K L q m 8 bjbj R bba G $ P d D l$ B ( : ( ( ) 0 X4 6 W Y Y Y Y Y Y $ ^ } 8 B/ N 0 8 8 } ( ) E E E 8 R ( ( ) W E 8 W E E # f " 7 ) | z9 H C 0 D İ : İ 7 7 İ ? 6 Z N7 @ E 7 4 7 6 6 6 6 } } ? 6 6 6 D 8 8 8 8 İ 6 6 6 6 6 6 6 6 6 B : Missouri State Emergency Management Agency2302 Militia Drive (65101)PO Box 116 (65102)Jefferson City, MissouriHazard Mitigation Grant Program (HMGP)Construction General Application Project ApplicationWhat is the Hazard Mitigation Grant Program?Authorized under Section 404 of the Stafford Act, the Hazard Mitigation Grant Program (HMGP) is funded by the Federal Emergency Management Agency (FEMA) to provide grants to State and local governments to implement long-term mitigation measures after a major disaster declaration. The purpose of the program is to reduce loss of life and property damage resulting from natural disasters by funding eligible mitigation measures to be implemented during the recovery from a disaster.1) Project must conform to Missouri's Hazard Mitigation Plan. To review the State of Missouri's Hazard Mitigation Plan, follow the link: HYPERLINK "https://sema.dps.mo.gov/docs/programs/LRMF/mitigation/MO_Hazard_Mitigation_Plan2018.pdf" https://sema.dps.mo.gov/docs/programs/LRMF/mitigation/MO_Hazard_Mitigation_Plan2018.pdf 2) Applicant must have a FEMA-approved Local Hazard Mitigation Plan, and the project must conform to the local plan.3) Project must provide a beneficial impact on the disaster area (i.e. the State of Missouri).4) Project must undergo environmental and historic preservation review process to ensure compliance.5) Project must solve a problem independently or constitute a functional portion of a solution, which as a whole will be completed.6) City/County must be NFIP compliant and a participant in good standing, if required.7) Project must be cost-effective and substantially reduce the risk of future damage, hardship, loss of life, or suffering resulting from a major disaster. Benefit-Cost Analysis:Projects funded by the HMGP must be cost-effective. To determine cost-effectiveness applicants must use FEMA's Benefit Cost Analysis Resource Kit Version available for download at www.bcahelpline.com. If you have problems with the download, contact FEMA's Technical Assistance Helpline. The Helpline can be reached from 9 am - 5 pm (ET), Monday through Friday, toll-free at 1-855-540-6744 or by e-mail at bchelpline@fema.dhs.gov. This application will require a BCA to be performed.Completing the HMGP Application:This application will enable you to apply for post disaster Hazard Mitigation Grant Program funding. This application is designed to capture the necessary information to meet program requirements. Applicants are encouraged to take ample time, read through the questions carefully, and complete each of the sections. This will enable you to move through the application process most efficiently. Project Applications and all attachments must be completed with templates provided on the SEMA website. Once complete, all required documentation will be submitted to the SEMA assigned grant manager by email. State mitigation staff will work with you to ensure your application is complete and correct. When the review is complete and the application packet is correct, you will be asked to email or send a flash drive including all original signatures, the final project BCA, attachments, and supporting documentation to: Missouri State Emergency Management AgencyAttn: Heidi Carver - Mitigation Section2302 Militia DrivePO Box 116Jefferson City, Missouri 65101MISSOURI STATE EMERGENCY MANAGEMENT AGENCY Hazard Mitigation Grant Program (HMGP) Application Applicant Information Rev.App.: Date: Multi-Hazard Local Mitigation Plan (LMP) Status: Approved Title of HMP: IF Approved: Plan Type: Multi-Hazard Local Mitigation Plan Date of Approval by FEMA: Date of Adoption: Project Title: Name of Applicant: County: Applicant Type: Type of Application: Federal Tax ID Number: . CID Number: UEI Number: FIPS Number: ... State Senate Legislative District(s): State House District: .. Congressional District(s): Member in good standing with the National Flood Insurance Program: Point of Contact: First Name: Last Name: Title: Organization: Street Address: City: State: MO Zip Code: Telephone: Fax: E-mail Address: Alternate Point of Contact: First Name: Last Name: Title: Organization: Street Address: City: State: MO Zip Code: Telephone: Fax: E-mail Address: Estimated Funding: Federal 75%Non-Federal %Total 100% Detailed Description of the Proposed Project Describe the problem to be mitigated Provide a detailed description of the proposed project: Does the project conform to the State and Local mitigation goals and/or plans? Explain (Cite location in plan(s) to support your answer): Will the proposed mitigation measure provide an independent solution to the problem? Explain: How does the proposed mitigation measure address a repetitive problem or a problem that poses a significant risk to public health and safety if left unresolved? Explain: Discuss the negative impacts on the area if the proposed project is not approved: Explain: Describe damage caused by previous and current disasters and associated costs: Hazards to be Mitigated/Level of Protection: Select the type(s) of hazards the proposed project will mitigate: Fill in the number of people and amount of property protected by the project. Number of People: 00000 Number of Residential Properties: Assessed Value of Residential Properties: $ Number of Commercial Properties: Assessed Value of Commercial Properties: $ Total Value of Above Structures: $ -------------------------------------------------------------------------------------------------------------------- Number of Residential Properties: Assessed Value of Residential Properties: $ Number of Commercial Properties: Assessed Value of Commercial Properties: $ Total Value of Above Structures: $ Total Number of Properties 000 Within Construction Sites: Number of Public Properties, Value of Public Properties, and the Value of Public Infrastructures are Provide the level of protection the proposed project will provide the total number of properties. List data in Flood Levels (10, 25, 50, 100, etc) or wind speeds (mph). S t r u c t u r e ( s ) p r o t e c t e d a g a i n s t t h e F O R M T E X T y e a r f l o o d . _ _ M o u n t i n g p o l e s h o l d i n g t h e w a r n i n g s y s t e m w i l l h a v e n e a r a b s o l u t e p r o t e c t i o n a g a i n s t 8 0 + m p h w i n d s p e e d s . T h e p r o p o s e d p r o j e c t w i l l p r o v i d e p r o t e c t i o n a g a i n s t t h e h a z a r d ( s ) s p e c i f ied above for years. Please explain the methodology used to determine the useful life of the project. (You can check the FEMA-standard for most project types.) Engineered Projects Only (e.g. Bank Stabilization, Small structural projects): Note: A Letter of Map Revision (LOMR) will not be needed on this type of project. There will not be any changes to the Flood Insurance Rate Maps (FIRM) which would necessitate the LOMR process. Attach to this page ALL engineering calculations used to determine the above level of protection. List all attachments below. Project Location: Site Address: (NOTE: If Acquisition, please use the Property Site Inventory Form.) State: MO Latitude of project location (decimal degrees): Longitude of project location (decimal degrees): Latitude (Lat:) and Longitude (Long:) verification: Accuracy appears Moderate to Good. Town Zip Code Latitude Longitude NOTE: Flood Insurance Rate Map (FIRM) showing Project Site (for each site location): FORMCHECKBOX Attach a copy of the panel(s) from the FIRM, and if available, the Floodway Map, with the project site and structures marked on the map. Maps can also be ordered from the Map Service Center at (877) 336-2627 or HYPERLINK "http://www.fema.gov/" http://www.fema.gov/. NFIP Community Number: Panel Numbers: CONTROL Forms.CheckBox.1 \s CONTROL Forms.CheckBox.1 \s CONTROL Forms.CheckBox.1 \s CONTROL Forms.CheckBox.1 \s Attach City or County Map with Project Site and Photographs (These are examples of the types of maps that can be used; additional space is provided to specify additional maps or references included in the application.) Check the appropriate boxes to indicate the attached maps: FORMCHECKBOX Attached copy of a city or county scale map (large enough to show the entire project area) with the project site and structures marked on the map. FORMCHECKBOX Attached are overview photographs. The photographs should be representative of the project area, including any relevant streams, creeks, rivers, etc. and drainage areas which affect the project site or will be affected by the project. FORMCHECKBOX For State Historical Preservation Officer's review, please attach photographs of the properties (at least 2 photographs each) at opposing angles so they may determine whether it is of historical value. A copy of each site photograph is included separately EACH PHOTO is CLEARLY LABELED HMGP Property Site Inventory Form (PSI) Owner Information: First Name: Co-Owner: Property Address: City: State: MO Zip Code: County Title Holder Post Mitigation (community undertaking project): Mitigation Property Site Action: FORMDROPDOWN Mitigation Property Site Comments: (***See Individual Pages of individual sites***) Legal Description: (___________. Comments: IV. History of Hazards/Damages in the Area to be Protected In this section describe all past damages from hazardous events in the project area. Include presidentially declared disasters as well as events that did not result in a Presidential declaration. Overview of Past Damages: Provide a detailed history of damages in the area, including direct and indirect costs. Include information for as many past incidents as possible. Attach any supporting documents. Direct costs should include damages to structures and infrastructure in the project area as a result of the hazard. Indirect costs should include the cost to the local government to respond to victims of the hazard in the project area, any interruption to local businesses, and losses of public services. DateLevel of EventDamagesIndirect Costs (Describe) FORMCHECKBOX List all Supporting Documentation Attached pertaining to Past Damages: Provide a narrative below describing historical damages in the proposed project area: V. Scope of Work/Budget: In this section, provide the details of all costs of the project. As this information is used for the Benefit-Cost Analysis, reasonable cost estimates are essential. Include up to 5% for Project Management in the line items below. REQUIRED for HMGP 5% initiative projects (e.g. sirens, generators): A complete BCA is not required, however narrative is required that addresses cost-effectiveness. See your SEMA Grant Manager for sample language. Materials/Services (Project Management should be included, if applicable. Quantity and Unit/Measure must be in whole numbers.) : ItemQuantityUnit / Measure Cost per UnitTotal Cost TotalsGrand Total (Total Project Costs):$ FORMTEXT F u n d i n g S o u r c e s : T h e m a x i m u m F E M A s h a r e f o r a H M G P p r o j e c t i s 7 5 % . T h e o t h e r 2 5 % m u s t b e p a i d b y t h e l o c a l s p o n s o r . N o t e : Y o u c a n n o t m a t c h f e d e r a l f u n d s w i t h f e d e r a l f u n d s ; t h e o n l y e x c e p t i o n i s C o m m u n i t y D e v e l o p m e n t B l o c k G r a n t ( C D B G ) funding. Funding SourcesFunding AmountPercentage of Total CostFederal Share (Estimated FEMA Share):75Non-Federal Share (See below for required details to document):25TOTAL Proposed Project Cost: FORMTEXT 100% Non-Federal Share Information: (Use Source 1, additional source space is available if multiple sources are contributing to the proposed project (Source 2 and Source 3). DescriptionSource 1Source 2Source 3Comments (Specify Other Source)Source Agency:County fundsSource Name of Non-Federal Share:Type of Non-Federal Share: Project Work Schedule: List the major milestones and timeframes (in monthly increments) for this project: MilestoneTimeframe Enter Whole MONTHSDescription: Contractor review/selectionDescription: Bidding/purchase xxxx Description: Site(s) preparationDescription: Procure required equipment for installation of xxxxDescription: Construction installationDescription: Test system (all areas)CloseoutDescri p t i o n : F O R M T E X T F O R M T E X T m o n t h ( s ) E n v i r o n m e n t a l D o c u m e n t a t i o n T h e a p p l i c a n t m u s t p r o v i d e c e r t a i n e n v i r o n m e n t a l d o c u m e n t a t i o n t o t h e S t a t e b e f o r e t h e S t a t e a n d F E M A c a n a d e q u a t e l y r e v i e w a n y p r o p o s e d p r o j e c t . T h e f o l l o w i n g s e c tions will help ensure you provide the necessary documentation for the project you are proposing. Each section below will begin with a specific question, in which you will provide either Yes, No, or Not Known as response. In each section, if you select Yes or Not Known for any of the answers, please indicate why in the comments section provided and any information about this project that could assist SEMA and FEMA in its review. Required: A Section 106 Form and process is available at: HYPERLINK "https://urldefense.com/v3/__https:/mostateparks.com/page/84261/section-106-review__;!!EErPFA7f--AJOw!A0nzbCd55jAQJb8jc2qgboVVHanCr0vzFkrxWSZND4DvlruyyJEsMWzYyIaWiCvntqXV8EPtrwfWwUgikA$" \t "_blank" https://mostateparks.com/page/84261/section-106-review National Historic Preservation Act Historical Buildings and Structures: Does your project affect or is it in close proximity to any buildings or structures 50 years or more in age? To help FEMA evaluate the impact of the project, please indicate below any other information you are providing: FORMCHECKBOX List all Supporting Documentation Attached pertaining to Historic Buildings or Structures: FORMCHECKBOX Additional Comments regarding Historic Buildings and Structures: National Historic Preservation Act Archeological Resources Does your project involve disturbance of ground? If yes, you must confirm that you have provided the following: FORMCHECKBOX A description of the ground disturbance by giving the dimensions (area, volume, depth, etc.) and location: FORMCHECKBOX The past use of the area to be disturbed, noting the extent of previously disturbed ground: FORMCHECKBOX A site map showing the location and extent of ground disturbance. To help FEMA evaluate the impact of the project, please indicate below any other information you are providing: FORMCHECKBOX List all Supporting Documentation Attached pertaining to Archeological Resources: FORMCHECKBOX Additional Comments regarding Historic Buildings and Structures: Endangered Species Act and Fish and Wildlife Coordination Act: Any request for information and associated response from the United States Fish and Wildlife Service (USFWS) or the Missouri Department of Conservation, regarding potential listed species present and potential of the project to impact those species. Required: Link to request and received response from USFWS for the Natural Heritage Review: HYPERLINK "https://naturalheritagereview.mdc.mo.gov" https://naturalheritagereview.mdc.mo.gov Are federally listed threatened or endangered species or their critical habitat present in the area affected by the project? If yes, you must confirm that you have provided the following: FORMCHECKBOX Information you obtained to identify species in or near the project area. Provide the source and date of the information cited. To help FEMA evaluate the impact of the project, please indicate below any other information you are providing: FORMCHECKBOX Any request for information and associated response from the United States Fish and Wildlife Service (USFWS) or the Missouri Department of Conservation, regarding potential listed species present and potential of the project to impact those species. FORMCHECKBOX List all Supporting Documentation Attached pertaining to the Endangered Species Act and Fish and Wildlife Coordination Act: FORMCHECKBOX Additional Comments regarding Endangered Species Act and Fish and Wildlife Coordination Act: Does your project remove or affect vegetation? To help FEMA evaluate the impact of the project, please indicate below any other information you are providing: FORMCHECKBOX List all Supporting Documentation Attached pertaining to Vegetation: FORMCHECKBOX Additional Comments regarding vegetation: Is your project in, near (within 200 feet), or likely to affect any type of waterway or body of water? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Not Known To help FEMA evaluate the impact of the project, please indicate below any other information you are providing: FORMCHECKBOX List all Supporting Documentation Attached pertaining to Waterway or Water Body: FORMCHECKBOX Additional Comments regarding Waterway or Water Body near your project: Clean Water Act, Rivers and Harbors Act, and Executive Order 11990 (Protection of Wetlands): Will the project involve dredging or disposal of dredged material, excavating, adding fill material or result in any modification to water bodies or wetlands designated as waters of the U.S. as identified by the US Army Corps of Engineers or on the National Wetland Inventory? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Not Known Executive Order 11988 (Floodplain Management): Does a Flood Insurance Rate Map (FIRM), indicate that the project is located in or will affect a 100 year floodplain, a 500 year floodplain if a critical facility, an identified regulatory floodway, or an area prone to flooding? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Not Known Does the project alter a watercourse, water flow patterns, or a drainage way, regardless of its floodplain designation? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Not Known Farmland Protection Policy Act: Will the project convert more than 5 acres of prime or unique farmland outside city limits to a non- agricultural use? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Not Known RCRA and CERCLA (Hazardous and Toxic Materials): Is there a reason to suspect there are contaminants from a current or past use on the property associated with the proposed project? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Not Known Are there any studies, investigations, or enforcement actions related to the property associated with the proposed project? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Not Known Do any project construction or operation activities involve the use of hazardous or toxic materials? FORMCHECKBOX Yes FORMCHECKBOX No If yes, please indicate below any other information you are providing to help FEMA evaluate the impact of the project: FORMCHECKBOX Comments and any relevant documentation. FORMCHECKBOX List all Supporting Documentation Attached pertaining to Hazardous and Toxic Materials: FORMCHECKBOX Additional Comments regarding Hazardous and Toxic Materials related to your project: FORMTEXT D o y o u k n o w i f a n y o f t h e c u r r e n t o r p a s t l a n d - u s e s o f t h e p r o p e r t y a f f e c t e d b y t h e p r o p o s e d p r o j e c t o r o f t h e a d j a c e n t p r o p e r t i e s a r e a s s o c i a t e d w i t h h a z a r d o u s o r t o x i c m a t e r i a l s ? F O R M C H E C K B O X Y e s F O R M C H E C K B O X N o F O R M C H E C K B O X Not Known Executive Order 12898, Environmental Justice for Low Income and Minority Populations: Are there low income or minority populations in the projects area of effect or adjacent to the project area? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Not Known FORMCHECKBOX List all Supporting Documentation Attached pertaining to Executive Order 12898 & your project: FORMCHECKBOX Additional Comments regarding Executive Order 12898: Other Environmental/Historic Preservation Laws or Issues: Are there other environmental/historic preservation requirements associated with this project that you are aware of? FORMCHECKBOX Yes FORMCHECKBOX No Are controversial issues associated with this project? FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Not Known Have you conducted any public meeting or solicited public input or comments on your specific proposed mitigation project? FORMCHECKBOX Yes FORMCHECKBOX No Summary and Cost of Potential Impacts: Having answered the questions in parts A. through I., have you identified any aspects of your proposed project that have the potential to impact environmental resources or historic properties? FORMCHECKBOX Yes FORMCHECKBOX No Maintenance Schedule and Associated Costs A. Provide a maintenance schedule including cost information: Identify entity that will perform any long-term maintenance: If the entity/responsibly party for regular long-term maintenance is different than the entity signing and certifying this application, please attach a letter from the entity accepting performance responsibility. Check the appropriate box below: FORMCHECKBOX No, a maintenance letter is not attached. If FEMA approves this application, the entity certifying this application is responsible for long-term maintenance for the proposed mitigation project. Alternative Actions A. It is important to demonstrate that you have balanced engineering feasibility, cost, and avoidance of adverse environmental impacts considering a range of reasonable alternatives. The section below will help you document the process in which you have selected the most feasible alternative. Describe the process you used to decide that this project is the best solution to the problem: B. You are required to show at least two alternatives to the project you are proposing, one as a default is No Action Alternative. List two feasible alternative projects to mitigate the hazards faced in the project area: 1. No Action Alternative: Provide discussion of the impacts on the project area if no action is taken: 2. Other Feasible Alternative: Discuss viable and practicable alternatives to the project including scope of work, engineering details (if applicable), estimated budget and the impacts of this alternative. a. Other Feasible Project Description and Scope of Work: Describe, in detail, the proposed project. Also, explain how the proposed project will solve the problem(s) and/or provide protection from the hazard(s). b. Other Feasible Project Location: c. Funding Sources: The maximum FEMA share for a HMGP project is 75%; other 25% must be paid by local sponsor. Note: You cant match federal funds with federal funds; only exception is Community Development Block Grant (CDBG). Funding Sources for the ALTERNATIVE ProjectFunding AmountPercentage of Total CostFederal Share (Estimated FEMA Share):75%Non-Federal Share (See below for required details to document):25%TOTAL Estimated Alternative Project Cost: FORMTEXT 100% Non-Federal Share Information: (Use Source 1), additional source space is available if multiple sources would contribute to the alternative project (Source 2). DescriptionSource 1Source 2Comments (Specify Other Source)Source Agency:Source Name of Non-Federal Share: FORMTEXT 2 3 < = d e / 0 ] ^ A B C D E F G H I J 7 9 : ⦘r h4^ h