LAND billing form FINAL- Rocky HillSubmitted by:
Local Acquisitions for Natural Diversity (LAND) Program
BILLING FORM
Municipality: Northampton
LAND Project #:. 24
Contract: CT ENV 110719 0000 0000001507
Project Name: Rocky Hill Greenway-Nashawannuck Northampton
Indicate any changes that may have affected answers to questions in your original LAND application
previously submitted to the Division of Conservation Services:
NONE
PROJECT COSTS EEA use only
Item Cost($) Date of Expenditure Eligible? Proo/of navment?
Acquisition $650,000 01/24/2020
Title exam(s)
Recording fees
Survey
Project total $650,000 -
Reimbursement rate:
LAND award:
Reimbursement request:
64%
$400,000 (64% is $416,000, but cap is $400,000)
$400,000
Did you apply for other state or federal funding? No (not for purchase, we have MVP for restoration)
Amount received - - - - - -
Amount received =$--- - - - - -
Agency: _
Agency: _
_ _ _
_ _ _
_ _ _ _
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Kevin Lake 4/7/2020
Signature of the Chair of the Conservation Commission Print Name Date
DCS use only:
Reimbursement request received Approved/denied
Reviewed Sent to fiscal office
Further information requested
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