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2020 Bayfield County Health Infrastructure Grant Application

  1. 2020 Bayfield County Health Infrastructure Grant Application

  2. The Bayfield County Health Infrastructure Grant is a community wellness initiative that promotes the health infrastructure of Bayfield County, its residents and visitors. The purpose of this grant opportunity is to provide the community with assistance to create the opportunity for a better place to live by supporting infrastructure for physical activity, promoting health and wellness.

  3. Please complete the following sections of the online application. Your completed application will be submitted to the email BayCoHD@bayfieldcounty.org. At that time, you may choose to have a copy emailed to you for confirmation and for your recordkeeping. You may also choose to submit your application by mail to: Bayfield County Health Dept., 117 E. 6th Street, Washburn, WI 54891. An email of a Word or PDF document is also an option - just email swartman@bayfieldcounty.org for a blank PDF or Word document. Note: Email or online applications are preferred.

  4. Application for project proposals must be received no later than Friday, May 1st, 2020. Awarding of grant amounts shall be at the sole discretion of the Bayfield County Health Infrastructure Committee. Grant funds must be used for pre-approved project costs. For details see please see Grant Description. If you have any questions regarding this grant opportunity or the application process, please contact Sara Wartman at Bayfield County Health Department at (715)373-3315 or email BayCoHD@bayfieldcounty.org.

  5. Applicant Information

  6. Overview

  7. Target Audience

  8. Project Description

  9. For example, what are you doing in your project and how will you carry it out?

  10. Project Site

  11. Please provide a photo or sketch of the proposed site for your project with your application.

  12. Is the land publicly owned?*

  13. Has the municipality endorsed this project?*

  14. Goals and Objectives

  15. Please craft goals and objectives. What are you trying to achieve and what strategies will you use to get there?

  16. List approximately 3 objectives to coincide with your goal.

  17. Optional

  18. Optional

  19. Timeline

  20. Please list the months with corresponding activities in the next box.

  21. List the activities during the selected months. Please explain what you hope to accomplish, start and end dates, etc.

  22. Partners and Community Support

  23. Describe the role that community members and collaborating partners will play in this project. Please include at least two letters of support from community members with this application to establish that the project has strong community impetus and determination behind the project.

  24. Project Impact and Sustainability

  25. In 4-5 sentences, please describe the anticipated impact on the community and plans for sustainability for this project after the project is completed.

  26. Will you be willing to have this site listed on an interactive Bayfield County map?*

  27. Budget

  28. Please complete a budget with anticipated expenses for each category of the project both for the grant funds and cost-sharing or match for the grant. Items that have a shaded box are not eligible for grant funds.

    Directions: Below, Column A or GRANT would be the contribution from the Bayfield County Health Infrastructure Grant. The minimum request is 1,000 total for grant expenditures and the maximum is up to $5,000. Under Column B or MATCH, this would be the local contribution from the town, municipality or tribe as well as contribution from community members, donated time, local permitting or contracting, etc. The total for Column B can exceed the amount requested from the Health Infrastructure (HI) Grant, but cannot be less than the amount requested (it is a 50/50 match grant). For example, if you are requesting $1,500 from the HI grant, then Column B must total at least $1,500 (or more) when totaling all expenses in that column. The last column on the far right is to total all rows and all costs, both grant and matching community contributions, to demonstrate all expenses projected.

  29. *******************************

  30. GRANT

    Column A

  31. MATCH

    Column B

  32. ESTIMATED COSTS

    A+B

  33. Equipment

  34. Materials and Supplies

  35. Contractual

  36. Labor (Volunteer)

  37. Not eligible for grant reimbursement

  38. Permitting/Other Fees

  39. Not eligible for grant reimbursement

  40. TOTAL:

  41. Add All in Column A

  42. Add All in Column B

  43. ALL COSTS (Matching and Grant)

  44. By submitting this grant application, the grantee agrees to allow photos and a community press release to be published on the finished project. Bayfield County assumes no responsibility or liability for any injury, loss or damage incurred as a result of use of any equipment on completed projects or resulting from construction of grant projects. Thank you for your time completing this application. Grant recipients will be announced on Friday, May 22, 2020.

  45. Leave This Blank:

  46. This field is not part of the form submission.