Green Infrastructure Application Name * First Name Last Name Email * Phone * (###) ### #### Organization Organization type Municipality School Church HOA/POA Company Non-profit Other Address * Please include the address of the proposed green infrastructure. If you have a specific location in mind or there is no listed address, please include the latitude and longitude in the second line (ex. 36.2621001, -94.2319499). Address 1 Address 2 City State/Province Zip/Postal Code Country Practices you are interested in installing: Check all that apply Rain garden Bioswale Pervious pavers, pavement, or ribbon driveway Vegetated roof Detention pond retrofit Green street Are you willing and able to maintain the green infrastructure for a minimum of 5 years following installation? * Yes No I need more information to decide. Briefly describe why you are interested in green infrastructure on your property: * Thank you for your submission!