1. Project Scope
A. The goal and purpose of this project?

B. If the project has a geographic boundary or location, please describe it and
provide maps, drawings, or photographs of the project area/location if appropriate.

C. Describe the management/administrative structure that will be responsible for
overseeing the initiation, completion, and monitoring of the study, including the RFP process and the required paperwork and record keeping requirements.

D. If the project will result in a property or facility that will require operation or
maintenance, please describe the management/administrative structure that will
be responsible for the operation and maintenance. Indicate if any agreements will be executed for the O&M. (Operation and maintenance agreements should be submitted to DCNR in draft form for prior approval of the provisions. DCNR reserves the right to require revisions to the provisions of such agreements.) Provide a resolution or letter from the agency responsible for the O&M committing to the long-term operation and maintenance of the property or facility. Provide an estimated cost of the yearly operation and maintenance of the property or facility.

E. Provide information on any other aspect of the project proposal appropriate for
DCNR and Commonwealth Partners' knowledge.

2. Correlation with Plan
A. Identify the section(s) or recommendation(s) of the Management Action Plan or
Special Purpose Study that support the need for the project being proposed. Explain how the project will enhance or support implementation of the Management Action Plan.

3. PHPP Goals
A. Please explain how the project will relate to or enhance the five goals of the
Pennsylvania Heritage Parks Program. If the project involves a partnership effort, supplemental documentation should be included that verifies the support by the participating partners. Support can be in the form of resolutions or letters from participating partners.

B. In explaining the impact the project will have on the local and regional economy,
please address factors such as attraction of tourists, job opportunities, small business development, revenue projections, public/private investment partnerships, etc

4. Project Work Plan/Cost Estimate
A. Please provide us a general work plan, including a time table and cost estimate,
to complete the project. The cost estimate should indicate which work items will
be paid in cash and which will be completed through in-kind or volunteer
services. The in-kind and volunteer services are not an eligible project cost for funding from the Pennsylvania Heritage Parks Program and cannot be counted as part of the required cash match for a PHPP grant. Only the costs being paid for in cash are eligible project costs.

Project Workplan:

B. Identify the sources of the cash match and indicate it they are public or private
funds. The cash match must be at least 50% of the total eligible project cost. An amount equal to at least 10% of the PHPP grant amount must come from private cash sources.**

C. Indicate the grant amount being requested. It cannot exceed $500,000 or 50% of
the total eligible project cost, whichever is less.

Grant request for PHPP funding:                   $
Required cash match:                                    $
Administrative Fee to EMHR, Inc.                $
Total:                                                           $

These cost estimate figures should agree with the figures presented on the Pennsylvania Heritage Parks Program Grant Application (2300-FM-RC0029).


5. Public Input
A. Please describe the process and system that will be used to ensure that
community/citizen involvement and public participation is an integral part of the project.

6. Ownership/Control
A. The project property or facility must be owned in fee simple title by a public agency or a non-profit organization with 501(c)(3) status, or must be controlled by a public agency or a non-profit organization with 501(c)(3) status through a lease agreement with a term and provisions acceptable to DCNR. Provide evidence of the ownership/control of the project property or facility. Forward a copy of the deed or lease agreement, or other document verifying ownership or control. (Lease agreements should be provided to DCNR in draft form for prior approval of the lease term an provisions. DCNR reserves the right to require revisions to the lease term and provisions.)

7. Public Use/Non-Discrimination
A. All properties or facilities funded with PHPP monies must provide a public
benefit. Properties and facilities available for public use and access shall not discriminate on the basis of race, religion, handicap, color, national origin, sex, or age. Please describe how this requirement will be met and provide

8. Support Documents
A. Provide support documents that will assist with the evaluation of the project
such as appraisal reports, site plans, floor plans, schedules of use, financial documentation, letters of support for the project, etc.

9. Environmental Analysis
A. Provide a comprehensive description of the existing environmental conditions of
the property or facility, addressing both present and past environmental impacts on and adjacent to the project site such as wetlands, toxic or hazardous waste sites, asbestos, junk yards, dumps, utility lines, other aesthetic intrusions or safety problems, etc. Explain how the environmental intrusions and impacts will be mitigated or minimized as part of or concurrent with the project proposal. (Based upon analysis of the information received, DCNR reserves the right to require a more comprehensive environmental assessment of the project property or facility.)

10. Submission of Other Data
A. DCNR may require, on a case-by-case basis, the submission of other data that it
deems necessary to support the project proposal.

NOTE: If a project is approved for PHPP funding, all plans and specifications for construction, rehabilitation, or restoration projects must be sealed by a registered professional from one of the three disciplines (architect, landscape architect, engineer) licensed to practice in Pennsylvania before the activity can commence. The plans and specs will also be reviewed by the Pennsylvania Historical Museum Commission for compliance with the Secretary of Interior's Standards for Rehabilitation. All plans and specifications must provide for handicapped accessibility in accordance with state and federal laws governing this requirement.

**Implementation Projects Chart
[50% PHPP money/50% cash match]

Project                                         Grant                             Cash                               Private
Amount                                        Amount                          Match                             Sources 1

$100,000                                   $ 50,000                        $ 50,000                          [$ 5,000]
80,000                                          40,000                           40,000                            [ 4,000]
60,000                                          30,000                           30,000                            [ 3,000]
50,000                                          25,000                           25,000                            [ 2,500]
30,000                                          15,000                           15,000                            [ 1,500]
25,000                                          12,500                           12,500                            [ 1,250]
10,000                                           5,000                              5,000                               [ 500]
7,500                                             3,750                              3,750                               [ 375]

1 The cash match has to include private money equal to at least 10% of the PHPP grant amount.