Sample Application (Simple Project)
This application is from the fictional Town of Simplicity, located in Prosperity County in the State of Any 
State (AS).  It is intended to represent any community that might apply for funding under the Hazard 
Mitigation Grant Program (HMGP).
Simplicity is a small town of approximately 5,000 citizens.  It is located in the valley of the Quake River, 
approximately 8 miles downstream from the larger city of Adversity.  The heart of Simplicity, a small 
historic, downtown area, was built in the early nineteenth century, approximately a half a mile from the 
river.  Surrounding downtown Simplicity is approximately 50 square miles of fairly rural, moderate- to low- 
income suburbs.  Most property owners maintain mobile homes or small houses on 1/8- to 2-acre lots.  
Approximately 100 property owners own land adjacent to the river.  Many of these residents periodically 
(every 5-10 years) suffer flood damage, while 50 regularly (every 1-2 years) fight rising waters.  Most 
recently, the Quake River flooded in April 1998, causing substantial damage to over 15 residential 
properties located adjacent to the river, south of Simplicity.  This project proposes acquisition of those 15 
properties, all of which are located in the Southby neighborhood, which were substantially damaged in 
this event and are flooded regularly.  Simplicity’s Mayor, Margaret Mayhem, is leading efforts to 
implement the property acquisition project.


Hazard Mitigation Grant Program
	Sub-Grant Application
	THIS SECTION FOR STATE USE ONLY
	
	? Standard  HMGP 
	? Initial Submission
	or 
	or
	? 5% Initiative Application
	?  Resubmission
?	Application Complete
	
?	Conforms with State Plan
?	In Declared Area
?	Statewide
	 Applicant Type:
?	State or Local Government
?	Private Non-Profit (Tax ID Received)
?	Recognized Indian Tribe or Tribal Organization
?	Special District/Other
	Project Type(s)
	? Flood              ? Seismic
	? Other:             ? Wind 
	________________________
	(Other)
	Community NFIP Status:
	?   NFIP Participant
	Community ID:  _________________________________
	
	?   In Good Standing
	?   Non-Participating
	State Application ID
	
	
	Application Rec’d (Date)
	
	
	Signed
	
	
	Date
	
	
	State 
	Reviewer 
	
	
	Reviewer 
	Phone #
	
	Reviewer 
	Fax #
	
	
	

1.  FEMA -
1769
-DR-
AS
	Part 1: Applicant Data
2.  Applicant Name:
Town of Simplicity, AS
3.  TIN:
987-65-4321
4.  County Name:
Prosperity
5.  County Code:

6.  State Code:
AS
7.  State Legislative District:
8th District
8.  U. S. Congressional District:
31st District
9.  FIPS Code:
098-09145
10.  Public Entity ID:

11.  CID:

12.  Primary Point of Contact
Name:
Terry Gilcrest
Nickname:

Organization:
Town of Simplicity
Job Title:
Property & Restaurant owner
Address:
Town Hall, Room 3
Telephone:
(111) 986-4993

100 Main Street
Fax:
(111) 986-4000

Simplicity, AS  40013
Email:
None
Directions:
From route 27, take Simplicity exit.  At stop sign, turn right onto US 41.  Follow 2 miles.  US 41 
turns into Main Street.  The Town Hall is at the corner of Main and 3rd.
13.  Alternate Point of Contact
Name:
NA
Nickname:

Organization:

Job Title:

Address:

Telephone:



Fax:



Email:

14.  Application Preparer
Name:
Terry Gilcrest
Job Title:
See above
Organization:
See above
Telephone:
See above
Address:
See above
Fax:
See above

See above
Email:
See above



15.  Does your community participate in the NFIP?
1
Yes
0
No
16.  If yes, what date did your community enter the NFIP?
January 1975
17.  If no, when do you anticipate entering the NFIP?
N/A

18.  What is the date of your community’s most recent Community Assistance Visit?
October 1993

19.  Is your community a private, nonprofit organization?
0
Yes
1
No
20.  Is your community an American Indian or Alaska Native tribal government?
0
Yes
1
No
	21.  Assurances
If the project is funded, the applicant must adopt an ordinance or other policy that demonstrate the 
community shall comply with the following (applicant, not preparer, must initial each item):
MM
Designate Authorized Agent for Project.
MM
All participants must sign a statement acknowledging the program is voluntary and, therefore, 
are not entitled to relocation assistance under the URA.
MM
Each potential property owner must be notified in writing that for the purpose of this program 
the community shall not use its power of eminent domain to acquire the properties if a 
voluntary agreement is not reached.
MM
The following restrictive covenants shall be conveyed in the deed to any property acquired:

1.	The property shall be dedicated and maintained in perpetuity for uses compatible 
with open space, recreational or wetlands management practices; and
2.	No new structure(s) shall be built on the property except as indicated below:
A.	A public restroom; or
B.	A structure that is compatible with open space, recreational or wetlands 
management usage and proper floodplain management policies and 
practices, which the Director approves in writing before the construction of the 
structure begins.
3.	The premises shall remain in public ownership.
4.	After completion of the project, no application for additional disaster assistance 
shall be made for any purpose with respect to the property to any Federal entity or 
source, and no Federal entity or source will provide such assistance.

In general, allowable open space, recreational and wetland management uses include parks 
for outdoor recreational activities, nature reserves, cultivation, grazing, camping (except 
where adequate warning time is not available to allow evacuation), temporary storage in the 
open of wheeled vehicles which are easily movable (except mobile homes), unimproved, 
pervious parking lots, and buffer zones.
MM
Any structures built on the property according to the above stipulations (see 2 above), shall 
be floodproofed or elevated to the Base Flood Elevation plus one foot of freeboard.


In addition, upon successful project approval and funding, the applicant will approve a formal, written 
policy, which will include all required ordinance language and applicable state policies.  Applicant will be 
required to submit its policy to state for final approval (applicant, not preparer, must initial each):
MM
A public meeting shall be conducted to explain policy and procedures.
MM
Priority of acquisition or relocation of properties shall be established.
MM
All structures to be demolished or relocated, including garages or outbuildings, shall be 
located on the acquired property.
MM
A standard policy of appraisal will be established.  Based on this appraisal, owners will be 
offered a fair market value (FMV) less any duplication of benefits as identified by FEMA.
MM
In the event that the appraisal less duplication of benefits is a negative figure or less than the 
land only value, and the property owner still desires to sell the property, the property owner 
will be offered the FMV of the land only (not the structure).  However, the community will take 
deed to both the structure and land.
MM
If subject property was purchased after the flood/event on an “as is” basis, the amount of the 
new post-flood owner paid for the property plus any verifiable improvements will be the FMV 
offered.  The post-flood property owner will not be offered the pre-flood FMV if they were not 
the property owner during/before the event.  In addition, any benefits the previous owner 
received for repair of the property will not be deducted from the offer.  In no event, will the 
offer to the post-flood owner exceed the pre-flood FMV.
MM
Any tenants renting properties 90 days prior to the start of negotiations with the owner will be 
offered relocation assistance.  Renter relocation assistance is formula driven but in no event 
will the relocation payment exceed $5,250 plus actual moving expenses.
MM
Each property closing will be preceded by a title search.  The title must be clear of all liens 
before the community will take title to the property.
MM
The property owner will agree to satisfy all liens or have the lien amount deducted from the 
purchase offer at the time of closing.
MM
Current property owners will be responsible for the property taxes from the first of the tax year 
through the date specified by the community buyout policy (e.g. either the date of closing or 
the date of the event) on a pro-rated basis.
MM
Until the title is transferred, the property owner remains solely responsible for the property.


22.  Authorized Agent of the Applicant/Community
Should our community be awarded FEMA funds to implement a property acquisition project, we agree to 
the above stipulations as conditions of receiving funds and implementing said project.

Margaret Mayhem

June 3, 1998


Authorized Agent’s Signature

Date


Margaret Mayhem

Mayor


Name (printed or typed)

Title

Part 2: Problems and Solutions
23.  Project Location
Describe, in detail, the location of your community’s project.  Include its topography and a map indicating 
all affected properties.  If possible, use a flood insurance rate map (FIRM). Identify any properties located 
in a floodplain or floodway.  Demonstrate how location contributes to the problem.  FIRMs typically are 
available from your local floodplain administrator, often within the planning, zoning, or engineering office.  You also 
can order maps from FEMA’s Map Service Center at 1-800-258-9616.  (For more information, contact your SHMO 
or visit FEMA’s web page at http://www.fema.gov/home/MSC/hardcopy.htm.)
Located in southeastern Simplicity, in the neighborhood of Southby, the proposed project location is a relatively flat 
lowland area with an overall slope towards the river.  The properties to be acquired are in the 10-year floodplain 
running parallel to the Quake River with banks generally 1 to 3 feet above normal (non-flood) river level, with a 
sharp drop off just prior to the water.  They are scattered along a 3-mile segment of the Quake River, with 8 homes 
closely built on the most northern 1 mile stretch of River Road, and the remaining properties on larger lots along the 
next 2 miles of the same road.  (See attached area map.)  This area is considered a Zone X by flood insurance rate 
maps of the area.  The first floor elevations of these properties range from 85 to 92 feet above sea level.  The base 
flood elevations range from 87 to 95 feet above sea level. (See attached FIRM.)
24.  Explanation of the Problem/Event
Describe in detail the event precipitating the need for this project and its effects on the community.  
Indicate if the event is a 100- or 500-year flood, etc., as appropriate.  Describe the historical effects of 
similar events during the past 25 years.  As supporting documentation, enclose photographs, scientific 
data (e.g. documented health risks, the number of homes or businesses destroyed by each event), etc.
In April 1998, much of Prosperity County suffered immense damage due to a 50-year flood of the Quake River.  In 
Simplicity, the flood caused the most damage to properties along the river, south of town.  A preliminary evaluation 
of post-flood structural conditions found 15 homes with significant damage from flood depths of 8 feet or more 
inside the structures, sustained for no less than 7 days.  All 15 homes have shifted from their foundations, have 
deterioration of major portions of their roofs and walls, and have significant health and safety risks due to sewage 
contamination from flooded a sewage system.
Due to Simplicity’s proximity to the Quake River, the community has experienced flooding on an average of once 
every three to five years for over half a century.  As exhibited in the attached Flood Insurance Study (FIS) for the 
area, the floods have crested from depths of 33 to over 50 feet at Lock 9, although the majority peak between 33 
and 40 feet.  With this flooding comes repeated physical, emotional, and economic damage totaling over 15 million 
dollars in just the last 25 years.


25.  Solutions to the Problem
Alternative #1:
Property Acquisition
Describe in detail the property acquisition alternative.  
*	How will your community’s acquisition (or acquisition and relocation) project solve the problem 
described?
*	Explain how it is effective in addressing a recurrent or repetitive problem.
*	Calculate the estimated cost including the present cost of implementation and the future cost of 
maintenance of the acquired property, as well as the potential future losses from natural disasters. 
The mitigation and disaster relief plan for the 1998 flooding is a program to offer acquisition to affected property 
owners on a voluntary basis.  All 15 properties in the Southby neighborhood are eligible since each has sustained 
over 50% damage in the flood of 1998, is located in the 10-year floodplain and has sustained at least 25% damage 
in at least 3 other floods over the past 20 years. Due to the extent of the damage and imminent health risks, 
relocation is not a viable option.  To date, 11 of the eligible property owners have voluntarily submitted offers to 
either sell their home to the Town of have expressed a potential interest in participating.  
By acquiring the proposed properties, Simplicity will remove flood-prone structures from the floodplain, thereby 
eliminating future damages, and health and safety risks for those homeowners and any potential rescuers.  This 
includes eliminating the need to provide emergency response services, subsidized flood insurance and federal 
disaster assistance to the residents.  
As noted previously, all of these properties sustained considerable damage on numerous occasions.  Including the 
costs of the most recent disaster, the total amount of disbursed disaster assistance far exceeds the fair market value 
of the properties. The table below illustrates the cost of repairing these homes from just the two most recent events.  
However, this does not illustrate the entire cost of hazard mitigation because it does not include the cost of 
emergency response services, replacing personal property, nor the emotional strain of living in a disaster-prone 
area.

Owner’s 
Name
Estimated 
FMV
Est. $ Loss 
in 1998
% Damage
$ Loss in 
1991
% Damage
Est. Replacement 
Value as of June 
1998
1.	Clabaugh
$54,630
$52,000 
95%
$7,300
13%
$51,898
2.	Florman
$50,724
$42,000 
83%
$14,500
29%
$47,680
3.	Morris
$41,850
$42,000 
100%
$13,000
31%
$38,920
4.	Banks
$60,012
$52,000 
87%
$6,500
11%
$56,411
5.	Schafer
$56,104
$39,000 
70%
$4,300
8%
$53,298
6.	Astatke
$73,908
$70,000 
95%
$37,000
50%
$69,473
7.	Blanca
$74,448
$60,000 
81%
$8,000
11%
$69,236
8.	Smith
$41,652
$28,700 
67%
$9,000
22%
$38,736
9.	Kagan
$69,372
$40,000 
58%
$17,000
25%
$65,209



Owner’s 
Name
Estimated 
FMV
Est. $ Loss 
in 1998
% Damage
$ Loss in 
1991
% Damage
Est. Replacement 
Value as of June 
1998
10.	Nazario
$65,196
$35,000 
54%
$10,000
15%
$60,632
11.	Sternman
$55,098
$32,000 
58%
$4,250
8%
$52,343
12.	Elkins
$55,000
$37,000 
67%
$5,000
9%
$51,700
13.	Goodin
$78,350
$41,000 
52%
$17,000
22%
$74,432
14.	Weiner
$45,980
$28,000 
61%
$13,000
28%
$43,681
15.	London
$67,772
$65,000 
96%
$42,000
62%
$64,383
Totals
$890,096
$663,700

$207,850

$838,032
The combined total of the fair market values of these 15 properties is $890,096.  The combined total of damages 
paid in just the last five years is $871,550.  Thus, in just the last five years, these property owners have collected 
disaster assistance approximately equal to the fair market value of all of their properties combined.  If Simplicity 
acquires these properties, we will eliminate the need for this type of payment in the future, despite any flooding in 
the area.



Alternative #2:
Floodwall or Berm
Describe in detail another mitigation measure (e.g., elevation, wet or dry floodproofing, detention ponds, 
drainage ditches, etc.) that is a feasible alternative solution to the problem described. 
*	How will this mitigation measure solve the problem described?
*	Explain how it is effective in addressing a recurrent or repetitive problem.
*	Calculate the estimated cost including the present cost of implementation and the future cost of 
maintenance, as well as the potential future losses from natural disasters.
Building a floodwall or berm would solve the flooding problem if it were long enough and high enough to protect 
the entire area.  However, the proposed project area is three miles long.  A floodwall of this size could not maintain 
the necessary stability to provide protection to such a large area.  Likewise, the high cost and the time necessary to 
build such a large floodwall reduces the feasibility and practicality of such a project.  By the time the building 
could be completed, it is likely that the area would suffer at least one more devastating flood.  In addition, the 
possibility still exists that floodwaters could rise above it.
A berm is also not guaranteed protection.   There is the possibility that flood waters could rise above it. In addition, 
berms erode, becoming less reliable as time goes by.  Thus maintenance of a berm would increase costs, and 
decrease reliability of protection.
An appropriate estimate for construction of a berm of this size is approximately $1,000,000.  Annual maintenance 
can be estimated at approximately $10,000-$20,000. Over a 100-year lifetime, total maintenance will cost 
approximately $1,500,000.  Potential damages are more difficult to estimate because they depend partially on the 
quality of maintenance.  However, assuming a high quality is maintained, only 100-year or 500-year floods are 
likely to exceed the berm.  Based on previous history, it is likely that six to eight floods will exceed the berm over a 
period of 100 years.  Depending on the actual flood depths, estimated damages from each of these events is from 
$200,000-$1,000,000.  Total potential future damages from the 100-year life of the project can therefore be 
estimated at approximately $2,000,000.
A floodwall of the same size could cost $3,000,000-$4,000,000 to implement, and another $100,000-$200,000 per 
year to maintain.  Over a 100-year project lifetime, implementation and maintenance could total over $15,000,000.



Alternative #3:
No Action
Describe in detail the “no-action” alternative solution to the problem described.
*	Explain the present and future effects of doing nothing to solve the problem.
*	Identify the estimated present and future costs and losses of doing nothing.
Calculations based on the history of flooding in Simplicity indicate that, with no action, Simplicity could expect to 
suffer further damage, injury or death of even greater magnitude in the future.  Assuming property owners would 
collect a similar amount of disaster assistance every five years, and assuming a 100-year lifetime of the project, the 
no action alternative could result in future disaster assistance payments of approximately $14,000,000 over the next 
100 years.
Rescue services and utility repairs can cost up to $500,000 per event.  Repair to damaged properties can cost up to 
$1,000,000 per event.  Assuming one event every five years, and assuming disaster and repair services cost from 
$100,000-$500,000 per event, and assuming property repairs cost from $100,000-$1,000,000 per event, over a 
project lifetime of 100 years, these services would total approximately $14,000,000.
Average cost
Number of events in 
100 years
Total average 
cost

$300,000 per event
(for disaster and repair services)

x 20
= $6,000,000

$400,000 per event
(for property repairs)

x 20
= $8,000,000
Total potential losses over 100-year project lifetime
= $14,000,000


26.  Proposed Solution
Of the three alternative solutions described above, which does your community propose is the 
best?
The Hazard Mitigation Plan developed by the State has established acquisition of flood-prone properties as its 
highest priority.  In addition, as individual residents and local officials became aware of the extent of damage again 
inflicted by spring flooding, they became increasingly interested in an acquisition project as a possible solution.  
This was confirmed at town meetings held on May 26, May 28, and May 30.  Representatives of FEMA, the State, 
and the Town met and discussed how property acquisition could greatly reduce future disaster losses, save lives, 
and lessen overall taxpayer costs.  Therefore, Simplicity has determined that an aggressive program of acquisition 
of flood-prone properties is its best alternative for reducing future losses.
Explain why your community proposes that solution over the other two alternatives.  
Demonstrate that it is the best solution of the three.  Compare the costs of future floods (e. g., 
disaster response, recovery, repair, reconstruction, etc.) to demonstrate its cost-effectiveness.
Owners of this project area have reported repeated physical danger, monetary loss and emotional stress due to 
repeated flooding.  
No Action: The No action option does nothing to reduce or eliminate future risk to residents or damage to their 
property.  Nor does it offer a means to reduce or eliminate the need for future disaster assistance.  
Building a Floodwall or Berm:  A floodwall is not a feasible option due to the lack of stability of a floodwall large 
enough to protect the area that must be protected , and to the extremely high cost of building such a floodwall.  A 
berm could reduce the risk and danger to property owners, but would not eliminate it.  A Benefit-Cost Analysis 
would show that the cost of building a berm is almost equal to the cost of acquiring the properties; But the benefit 
of permanently removing property owners from the path of the flood is much greater than trying to control the river 
and possibly failing.  If the people are moved out of harm’s way, there is no chance of failure.
Property Acquisition: Acquiring this property and converting it to open space in perpetuity is the only means of 
ensuring the safety of residents and eliminating future government disaster assistance and repair expenses.  The 
present cost of repair is over 50% of the cost required to fund a property acquisition project.  By removing residents 
from the path of danger, we will ensure that no future aid is required.


Part 3: Estimated Budget
27.  Budget Worksheet

Unit Cost
# of Units
Total Cost
Site Acquisition (total estimated FMV’s from Property 
Inventory—Summary)


$
890,096
Appraisal
$
500
15
$
7,500
Property Survey
$
500
4
$
2,000
Title Search and Closing
$
1,000
15
$
15,000
Structure Demolition
$
10,000
15
$
150,000
Structure Relocation  
$
0
0
$
0
Tenant or Housing  relocation assistance
$
6,000
3
$
9,000
Legal fees

$
4,500
Other: 
NFIP insurance premium reimbursements (for 11 people at 5 years 
each)
$
32,274
Other: 

$

Total Cost Estimate (sum of all total costs)
$
1,110,370
NOTE:  Administrative funds will be provided in addition to grant award if project is approved.  
Do not include administrative expenses in above Total Cost Estimate.

28.  Basis of FMV:
Fair market value will be based on post-disaster property values. The application preparer used property tax 
assessment data to estimate a working budget.  However, we plan to base final purchase offers on appraisals 
completed by a State licensed professional appraiser from Prosperity County.  For those property owners who are 
interested in obtaining a second appraisal, we will provide a list of appraisers from the county whose appraisals will 
be considered acceptable.
29.  Projected Source of Funds:

Source

Percent

Amount
Federal Share:
FEMA

75%
$
832,778

Non-federal 
Share:
(State, local, 
private)
State

22%
$
244,281

CDBG

3%
$
33,311




$



30.  Work Schedule:
Include a work schedule showing milestones and their anticipated periods of performance.
Projected Work Schedule
Task
Estimated time to complete
1.	Announce receipt of grant
2.	Update list of interested property owners
3.	Appraise properties
4.	Distribute offer letters
5.	Accept any second appraisals
6.	Begin closing proceedings
7.	Close on properties
8.	Relocate or demolish any remaining structures
9.	Implement open space plan
10.	Maintain open space
1 week
1 week
3-6 weeks
1-3 weeks
1-3 weeks
1 week
2-4 weeks
3-6 weeks
6-12 weeks
Ongoing
Total Time Estimate
6-9 months
*Please note that some tasks may overlap or occur simultaneously.
Part 4: Property Inventory
Use the property inventory forms (items 31, 32, and 33) to document properties targeted for acquisition.  
Make copies of the forms, as necessary, number copies, and attach.

Also please answer the following questions.  If the question is not applicable to your project, write “N/A” 
or “not applicable” in the blank.
The average cost of one square foot of residential rental property in 
Simplicity
is 
$ .45-.55
FOR PUBLIC FACILITIES ONLY (attach additional pages, if necessary, to answer for each public facility to be acquired):
Type of facility (e.g. fire station, community center, etc.):
N/A
Annual Budget:
$


Rental Income (if any):
$




31.  Property Inventory—Summary
Sequential 
#
Lot or Parcel #
Property Owner’s Name
Property’s Street Address & Zip Code
Estimated FMV
1
412-0091-037
Todd Clabaugh
1421 River Road
$54,630



40232

2
412-0091-041
Mrs.  Tammy Florman
1572 River Road
$50,724



40232

3
412-0091-048
Mr. and Mrs. D. Morris
1583 River Road
$41,850



40232

4
412-0091-052
Leslie and Jim Banks
1591 River Road
$60,012



40232

5
412-0091-059
Mr. Joel Schafer
1596 River Road
$56,104



40232

6
412-0091-060
Mr. and Mrs. Haluyante Astatke
1600 River Road
$73,908



40232

7
412-0091-066
Mr. and Mrs. Dano Blanca
1654 River Road
$74,448



40232

8
412-0091-067
Ms. Patrice Smith
1679 River Road
$41,652



40232

9
412-0091-070
Steven and Lisa Kagan
1700 River Road
$69,372



40232

10
412-0091-083
Isabel Nazario
1833 River Road
$65,196



40232

11
412-0091-088
Mr. John Sternman
1887 River Road
$55,098



40232

12
412-0091-090
Lee and Toni Elkins
1901 River Road
$55,000



40232

13
412-0092-000
Mr. and Mrs. Robert Goodin
2006 River Road
$78,350



40232

14
412-0092-009
Mr. Alex Weiner
2099 River Road
$45,980



40232

15
412-0092-010
Charles London
2100 River Road
$67,772



40232

Total Estimated FMVs this page
$890,096


32.  Property Inventory—Individual
Sequential #:
1
of
15
	A.  Owner(s) Data
Name:
Todd Clabaugh
Social Security #:
224-09-7654
Phone
Day:
(111) 678-9012
Evening:
(111) 426-1134

Mailing Address:
511 Tyler Lane


Simplicity, AS  40222

Name:
N/A
Social Security #:

Phone
Day:

Evening:


Mailing Address:





	B.  Tenant Data (if applicable) (If more than one tenant use 33, Property Inventory—Tenant 
Data sheet.)
Name:
N/A
Social Security #:

Phone
Day:

Evening:


Mailing Address:





Identify Possible Sources of Disaster Assistance for DOB (check all that apply):
1
NFIP Settlement
0
State IFG Program
0
SBA Loans
1
Disaster Housing (DH) Program
0
Hazard Minimization Funds


0
Other:

Summarize building permit data below (include date of permit and purpose).

N/A




Has this structure ever been flooded before?
Yes





FOR BUSINESSES ONLY:
If yes, complete the following:

Type of business:
N/A


Date
Water depth above first 
finished floor

Monthly cost of rental space:






Estimated value of contents:



1998
7 ½ feet

Description of contents:

1991
6 inches



1989
15 inches



1984
3 ½ feet



1978
2 feet

Number of lost business days:







Attach a detailed street map with exact location of property.  Is map attached?
YES




	C.  Property Data  
Lot or Parcel #:
412-0091-037

Street Address:
1421 River Road

Zip Code:
40232
Type of Property (check one):
0
Single-family Home
0
House of Worship

1
Mobile Home with Pad 
0
Multiple-family Home
0
Vacant Lot

1
Own home pad
0
Commercial
0
Other 


0
Rent home pad
Number of stories? (Not including basement)
1
Does the building have a basement?
0
Yes
1
No
Type of Construction (e.g. wood frame, masonry, etc.)
Wood frame

Type of Foundation (e.g. post and pier, continuous perimeter, etc.)
Continuous perimeter

What is the date of initial construction?
1975

What is the total square footage of all buildings?
850
square feet
As of the date of application, are any structures on the property 50 years old or older?
0
Yes
1
No
What is the property’s Flood Zone Symbol or Designation?
B

Is property in a floodway?
0
Yes
1
No
What percentage of the property is 
damaged?
95
% 
Is property in a floodplain?
1
Yes
0
No
If yes, describe floodplain (e.g., 10-, 
25-, 50-, 100-, or 500-year):
10
-year
What is the first floor elevation (FFE) of the property?

feet above sea level (NGVD)*
What is the base flood elevation (BFE) of the property?

feet above sea level (NGVD)
What is the flood water elevation for the current event?

feet above sea level (NGVD)

*National Geodetic Vertical Datum
Attach color photographs.



Part 5: Environmental and Sociological Considerations
For each Hazard Mitigation alternative your community is considering, answer “Yes,” “No,” or 
“Possibly,” or “Don’t Know” to each question.  Then compare the columns.  The column with the 
most “No” answers is the most community-friendly alternative.
34.  Matrix of Environmental and Sociological Effects 

Proposed 
Action
Alternative 
#2
No Action
Land Use & Socioeconomic Issues
1.  Will project hinder or violate general land use in the 
area?
No
Yes
No
2.  Will project conflict with local zoning ordinances?
No
Possibly
No
3.  Will any structures be relocated?
No
No
No
4.  Will project negatively affect area economic activities?
Possibly
No
Possibly
5.  Will project have a disproportionately high or adverse 
affect on a minority/low-income population?
No
No
No
6.  Will project decrease or hinder prime farmland?
No
Don’t Know
No
Natural Resources
7.  Will marine, aquatic or terrestrial vegetation be 
removed?
No
Possibly
No
8.  Will there be construction in marshlands or wetlands?  
Will the project adversely affect any wetlands areas?
No
Yes
No
9.  Do endangered or rare species live in the project area?
Possibly
Possibly
Possibly
10.  Is the project area in or near a wildlife conservation 
area?
No
No
No
Archeological and Historical Resources
11.  Does project area have any archeological, cultural or 
historical significance?
No
No
No
12.  Will project require excavation or disturbance of soil?
No
Yes
No
Total “No” Responses:
11
5
11


Also consider hazardous materials that may be found on the properties you plan to acquire.  
Answer “Yes,” “No,” or “Possibly,” or “Don’t know” to each of the following questions.  If the 
answer is “Yes” for even one property, then answer “Yes” to the question.  For any question to 
which your answered “Yes” or  “Possibly,” please attach additional pages explaining each 
hazardous material and planned abatement of each.
Hazardous Materials
1.  Were the properties previously or are the properties currently used for 
commercial, light industrial, transportation or institutional purposes?
No
2.  Are there any above ground storage tanks, underground storage tanks, or leaking 
storage tanks present on the properties?
Possibly
3.  Is there presently, or has there been in the past, any generation, treatment, 
storage, disposal, release, or spill of petroleum products, solid or hazardous 
substances and/or wastes, other than normal quantities of household substances on 
the properties?
Don’t Know
4.  Have unusual odors or discoloration been noticed in the soil, or drinking or surface 
water on or near the properties?
No
5.  Are there any past or ongoing environmental investigations conducted by federal, 
state, local government agencies, or private firms; or Occupational Safety and Health 
Administration (OSHA) citations or notices of violation on the properties related to 
environmental or toxic hazards?
No
6.  Are there any other issues or concerns associated with hazardous or toxic 
materials on the properties?
No
35.  Agency Contacts
Identify the state and federal agencies contacted in the development of the project and in the 
preparation of this environmental analysis.  In Part 6: Attachments, be sure to include letters 
from the State Historic Preservation Officer regarding historic buildings and archeological 
resources; and the U.S. Fish and Wildlife Service regarding endangered and threatened 
species, and fish and wildlife conservation issues.
1
1
1
0

State Historic Preservation Office
U.S. Fish and Wildlife Service
State Division of Environmental Protection 
State Division of Natural Resources
0
0
0
0
0
U.S. Department of the Interior 
U.S. Environmental Protection Agency 
U.S. Geological Survey 
U.S. Natural Resources Conservation Service 
Other:   State Dept. of Social Services


36. Sociological Questions
Please respond to the following in regards to your community’s proposed solution.
1.	Identify and describe any historic resources on or near any of the properties.  Explain 
how the project will effect those historic resources.
The project area has no historical significance.
2.	Identify and describe any archeological sites on or near any of the properties.  
Explain how the project will effect those archeological sites.
The closest archeological sites are over 15 miles from the project area.  According to the SHPO  (see attached 
letter), this project should have no effect on those sites or any other areas of archeological significance.
3.	Identify and explain any significant cultural or social issues that might affect or be 
affected by the project.
There are no minority families living in the project area.  Some properties are owned by low-income 
residents, however it is the position of the Town that acquisition of their properties will benefit them by 
providing an opportunity to purchase a new residence where they will not have to live with the fear and 
trauma associated with living in a floodplain.
4.	Identify and explain any economic concerns or issues that might affect or be affected 
by the project.
The county has no major economic concerns or issues as no business areas are affected by this project.  
However, 11 property owners living in project properties will probably qualify as low-to-moderate income 
(LMI) and may require additional relocation assistance.


5.	Identify and describe abatement of any hazardous materials (e.g., lead, asbestos, 
septic tanks, heating oil tanks, etc.) on any of the properties.
At present, property owners are responsible for appropriate disposal of any known hazardous materials that 
they are capable of removing (paint, pesticides, etc.).  Other known hazardous materials include septic tanks, 
heating oil tanks and asbestos.  Included in the estimated cost of demolition are funds to hire a special 
contractor to drain and fill all underground septic tanks and heating oil tanks, to drain and remove all above-
ground septic tanks, and to properly collect and dispose of any asbestos coated building materials.  If any 
other hazardous materials are found during demolition, either the demolition contractor will dispose of them 
appropriately or the Town will extend the scope of work for the special contractor.
Part 6: Authorized Signatures
37.  Project Official Chief Executive Officer of the Applicant/Community
I certify that I am the authorized agent for the applicant having purview over the development and 
completion of this application, and all statements and information contained herein are true and 
accurate.

Margaret Mayhem

June 3, 1998


Authorized Agent’s Signature

Date


Margaret Mayhem

Mayor


Name (typed or printed)

Title

I certify that I am the chief executive officer of the applicant and the above named individual is the 
authorized agent acting on our behalf for this application.

Margaret Mayhem

June 3, 1998


CEO’s Signature

Date


Margaret Mayhem

Mayor


Name (typed or printed)

Title


Before submitting this application, ensure you have provided all 
requested information.  An incomplete application may result in 
an unfavorable evaluation, or delay of HMGP funding.  List all 
attachments and enclosures on the next page.


Part 7: Attachments and Enclosures
38.  Attachments
Use the space below to name and number all attachments and enclosures.  Use as many pages as 
necessary to list all documents neatly and completely.
Be sure to include copies of the following:
Maps of project area:
?	Street map
?	FIRM
?	Topographical and other maps, if available
Other supporting documentation:
?	Copies of letters from environmental agencies
?	Advertisements for project meetings
?	Photographs of damage and other evidence
?	Property data
List of Attachments and Enclosures
Number
Title or Description

































Tool II-7, Sample Application (Simple Project)
Tool II-7, Sample Application (Simple Project)
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