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                  <text>Xenia Rural Water File</text>
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                  <text>Documents related to the project connecting Dana to Xenia Water.</text>
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                  <text>Dana, Greene County, Iowa</text>
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              <text>XENIA RURAL WATER DISTRICT [letterhead]

Dear Potential Customer:

Xenia Rural Water District is planning a construction project to service your area with treated water. We
are distributing this information to individual households to assure that all interested parties have the
opportunity to get rural water service if they desire. The distribution design for western Boone
County and eastern Greene County has been completed. The areas within these boundaries that
exhibit the most interest and the distribution lines that are most feasible for construction will be
built first, with the remaining areas to follow according to interest and feasibility.

Enclosed are the following:

1. Expansion Sign-up Information sheets 5. Easement Responsibilities Sheet
2. Consider the Cost analysis 6. Tile Repair Sheet

3. Rate Sheet 7. Limited Easement Copy

4. Positive Disconnect Specs sheet 8. Water User’s Agreement

To sign-up for water service we need the Water User’s Agreement signed by the property owner and
returned with the $300.00 membership fee or a $50.00 deposit as soon as possible. The remaining
$250.00 balance will be due at bid-letting. Anytime during the project the cost is $300.00 for

membership, after the project is closed the cost will be the current membership fee plus materials and
installation. We will follow up with an easement at a later date.

If you choose to sign the Water User’s Agreement and send in the $300.00 membership fee or the
$50.00 deposit, please keep the pink copy of the form for your records. We would need your name,
address, phone, and a legal property description printed at the top of the form, and the date and signature

at the bottom. A receipt will be mailed to you. If the project does not go through, your money will be
refunded.

If you have any questions, please call the office.

Sincerely,

Xenia Rural Water District

119 Main Street • P.O. Box 459 • Woodward, Iowa 50276
Office: 515-438-2944 • Fax: 515-438-4352

[page 2]

WATER USER’S AGREEMENT:

A Water User’s Agreement must be signed by the property owner for each meter. The Water User’s
Agreement is a contractual arrangement between the participating member and Xenia. The participating
member is responsible for reading their own meter. The agreement states that the participating member
is responsible for the minimum monthly payment plus any water usage in excess of the minimum. It also
states that a Limited Easement will be granted to Xenia to install the service on your property. The District
will pay to each person granting a Limited Easement $.08 per linear foot of property on which the water
line will be placed. To terminate the contractual arrangement, a lump sum payment would be required.
This payment is equal to the average initial project development cost per member based upon the total
initial cost of the District’s water supply, treatment, transmission and distribution system, and calculated as
of the date of the member’s failure to pay, or his cancellation or voluntary termination. After ten years,
your cost would be equal to Xenia’s cost to remove the meter pit from your property, currently $210.00.

METER AND LINE PLACEMENT:

The main line is normally placed approximately 50 feet from the center of the road. Your meter pit will be
placed at your discretion along this line approximately 5 ft. inside the main line, unless hindered by natural
and/or man-made barriers or obstructions. If the main line is on the other side of the road, your meter will
be placed at your discretion along a horizontal line between your property line and 15 ft. from the property
line, unless hindered by natural and/or man-made barriers or obstructions. We will try to avoid natural
landscaping when possible.

CLEAN-UP:

The trenchline area will be obvious after installation. When the project is entirely completed, the
contractors will return to smooth and level the area. This could be several months after the initial
installation. Time is required to allow the dirt to settle before clean-up work can begin. The contractors
will not re-seed. This will be the property owner’s responsibility. Anytime there is underground
construction, it will take some time for the area to return to its original condition.

[page 3]

CONSIDER THE COST
Figures for 1997

Most private well systems cost more than twice as much as our non-profit total system when depreciation
and interest costs are considered.

Typical Well System (1995 Costs)

Installed Cost Useful Life Monthly

(years) Depreciation
Well $4,200.00 40 $ 8.00
Well Pump $ 650.00 5 $ 11.00
Pressure Tank $ 225.00 10 $ 2.00
Water Softener $ 600.00 3 $ 17.00
Total $5,675.00 $ 38.00

In addition to the above charges there are the following monthly charge:

Salt $ 10.00
Operation and Maintenance $ 5.00
Interest on Installation $ 47.00
Total Monthly Cost $ 100.00

**Your private well system is depreciating or reaching the end of its useful life each day.

XENIA RURAL WATER DISTRICT
Average Usage

The average XRWD member currently uses 5,000 to 6,000 gallons of safe, treated water each month at a cost
of $60.00 to $65.00. This includes depreciation and interest costs.

Water Consumption

Water consumption data from rural users indicate an average daily household consumption of approximately
55 gallons per capita. The values shown below can be used in estimating the average monthly total user
consumption from the District system. NOTE: gpd = gallons per day gpm = gallons per month

DAILY MONTHLY
ITEM DEMAND DEMAND
People 55 gpd/person 1650 gpm
Hogs
-Sows &amp; Boars 2 gpd/animal 60 gpm
-Feeder Pigs 0.5 gpd/animal 15 gpm
-Fat Hogs 1 gpd/animal 30 gpm
Beef/Cows
-Brood Animals 12 gpd/animal 360 gpm
-Feeder Calves 8 gpd/animal 240 gpm
-Fat Cattle 12 gpd/animal 360 gpm
-Milking 25 gpd/animal 750 gpm
-Dry Cows, Heifers 10 gpd/animal 360 gpm
Sheep
-Ewes &amp; Bucks 1 gpd/animal 30 gpm
-Feeder Lambs .3 gpd/animal 9 gpm
- Fat Lambs .5 gpd/animal 15 gpm
Horses 6 gpd/animal 183 gpm
Chickens .06 gpd/animal 1.8 gpm
Turkeys .3 gpd/animal 9 gpm

[page 4]

NW Trans., Boone East Rate

GALLONS | BASE PLUS TAX | LATE PAYMENT | BASE | 6% TAX
0-2000 | $37.10 | $40.60 | $35.00 | $2.10
3000 | $47.70 | $52.20 | $45.00 | $2.70
4000 | $58.30 | $63.80 | $55.00 | $3.30
5000 | $63.60 | $69.60 | $60.00 | $3.60
6000 | $68.90 | $75.40 | $65.00 | $3.90
7000 | $74.20 | $81.20 | $70.00 | $4.20
8000 | $79.50 | $148.74 | $75.00 | $4.50
9000 | $84.80 | $157.62 | $80.00 | $4.80
10000 | $90.10 | $166.50 | $85.00 | $5.10
11000 | $93.28 | $173.16 | $88.00 | $5.28
12000 | $96.46 | $179.82 | $91.00 | $5.46
13000 | $99.64 | $186.48 | $94.00 | $5.64
14000 | $102.82 | $193.14 | $97.00 | $5.82
15000 | $106.00 | $199.80 | $100.00 | $6.00
16000 | $109.18 | $206.46 | $103.00 | $6.18
17000 | $112.36 | $213.12 | $106.00 | $6.36
18000 | $115.54 | $219.78 | $109.00 | $6.54
19000 | $118.72 | $226.44 | $112.00 | $6.72
20000 | $121.90 | $233.10 | $115.00 | $6.90
21000 | $125.08 | $238.65 | $118.00 | $7.08
22000 | $128.26 | $244.20 | $121.00 | $7.26
23000 | $131.44 | $249.75 | $124.00 | $7.44
24000 | $134.62 | $255.30 | $127.00 | $7.62
25000 | $137.80 | $260.85 | $130.00 | $7.80
26000 | $140.98 | $266.40 | $133.00 | $7.98
27000 | $144.16 | $271.95 | $136.00 | $8.16
28000 | $147.34 | $277.50 | $139.00 | $8.34
29000 | $150.52 | $283.05 | $142.00 | $8.52
30000 | $153.70 | $288.60 | $145.00 | $8.70
31000 | $156.88 | $294.15 | $148.00 | $8.88
32000 | $160.06 | $299.70 | $151.00 | $9.06
33000 | $163.24 | $305.25 | $154.00 | $9.24
34000 | $166.42 | $310.80 | $157.00 | $9.42
35000 | $169.60 | $316.35 | $160.00 | $9.60
36000 | $172.78 | $321.90 | $163.00 | $9.78
37000 | $175.96 | $327.45 | $166.00 | $9.96
38000 | $179.14 | $333.00 | $169.00 | $10.14
39000 | $182.32 | $338.55 | $172.00 | $10.32
40000 | $185.50 | $344.10 | $175.00 | $10.50
41000 | $188.68 | $349.65 | $178.00 | $10.68
42000 | $191.86 | $355.20 | $181.00 | $10.86
43000 | $195.04 | $360.75 | $184.00 | $11.04
44000 | $198.22 | $366.30 | $187.00 | $11.22
45000 | $201.40 | $371.85 | $190.00 | $11.40
46000 | $204.58 | $377.40 | $193.00 | $11.58
47000 | $207.76 | $382.95 | $196.00 | $11.76
48000 | $210.94 | $388.50 | $199.00 | $11.94
49000 | $214.12 | $394.05 | $202.00 | $12.12
50000 | $217.30 | $399.60 | $205.00 | $12.30

[page 5]

The installation of the participating member’s service piping and apparatus shall be
installed by a qualified person or plumber. The installation must be done to create a
positive disconnect from any existing well to prevent cross-connection.

POSITIVE DISCONNECT SPECS

[Diagram: XRWD LINE to VALVE 1, UNION 1, pipe, UNION 2, VALVE 2, TO HOUSE. A branch runs through VALVE 3, UNION 3, pipe, UNION 4 and VALVE 4 to the FARM WELL/PRESSURE SYSTEM.]

There is a 5' long PVC pipe, 1 1/2" in diameter to tie onto. Do Not dig up next to the pit.

The line is connected with compression fittings and line pressure will move the pit and
the 5' PVC tie. To insure this does not happen, do not dig past the stake marking the end
of the 5' tail, and properly block your service line. The participating member shall install
and maintain a private cut-off valve on the participating member’s side of the meter. The
District is to provide a like valve on the District’s side of the meter.

1. When using the XRDW water supply, valves 3 &amp; 4 should be shut
and pipe B shall be removed by uncoupling unions 3&amp; 4.

2. When using the farm water system, valves 1 &amp; 2 should be shut
and pipe A shall be removed by uncoupling unions 1 &amp; 2.

3. The cross connections may be located at the convenience of the

property owner, such as an existing well pit, pump house, or in
the basement of the house.

4. The purpose of the positive disconnect policy is to prevent

accidental contamination of the XRWD system by water from a
private well.

A cross connection is simply an arrangement of the pipes by which allows a supply of
potable drinking water to become contaminated. It occurs when water flows in the wrong
direction, even though it may only be for a split second.

[page 6]

EASEMENT RESPONSIBILITIES
Xenia Rural Water District is a 357A organization, which is a rural water district. The purpose of this
project is to supply people with potable water at the lowest cost possible. We are funded through USDA
Rural Development and therefore operate under their guidelines for construction projects.
XENIA’S RESPONSIBILITIES:
1. We will fix all tiles (see attachment).
2. We will fix all fences.
3. We will come back and dress the trench area.
4. If a driveway is trenched, we will put replacement gravel as needed over the trench.

5. If there are problems with a tile after construction is completed:

a. Notify Xenia of the situation: we will execute a tile agreement with you before
any work is done.

b. You may hire a reputable contractor of your choice to dig up the problem area.
Xenia MUST have an inspector on site during repair.

c. If the problem was caused by Xenia during construction, Xenia will pay for all
repairs to the tile and reasonable crop damage associated with the tile problem, as
deemed by the Board of Directors.

d. If the problem was not caused by Xenia’s construction, the property owner will
pay for all repairs.

6. If there is a water leak in one of the District’s lines, and crop damage occurs when fixing
that leak, Xenia will pay reasonable crop damage.

7. Xenia will try to avoid trees, shrubs, wind breaks, etc.

8. Xenia will pay reasonable crop damage if we have to relocate lines.
9. Xenia can not pay for crop damages during initial construction.

10. Xenia can not re-seed lawns, pastures, or other perennials.

If Xenia is not granted an easement at time of construction, all Xenia’s additional costs of laying pipe in the
road right-of-way will be assessed to the property owner before water service will be made available.

[page 7]

[Diagram, printed sideways on the sheet]

TILE LINE REPAIR
NO SCALE

REPLACE BROKEN TILE WITH EQUALLY SIZED, CL.160 PVC PIPE. FOR TILE SIZES LARGER THAN 12" USE PVC CL.100 IRRIGATION PIPE. FOR SIZES LARGER THAN 15" REPAIR WITH EQUAL MATERIAL.

WRAP JOINTS WITH PVC CLIPS (6" MIN. WIDTH)

EXISTING TILE LINE

REMOVE BROKEN TILE BACK TO NEXT JOINT AND SOLID GROUND

GRAVEL FILL BELOW REPAIR TO PREVENT LINE SETTLEMENT

12" minimum

[page 8]

(FMHA Approved)
LIMITED EASEMENT
No. ____
RE:
[blank form]

The undersigned, as Owner(s) of record of the real estate described above, for one dollar and other good and valuable consideration received,
hereby grant(s), sell(s), transfer(s) and convey(s) to Xenia Rural Water District (the “District"), its successors and assigns, an affirmative and
perpetual easement in, to, and running with the real estate described above, together with a general and perpetual right of ingress and egress
upon such real estate, LIMITED AS FOLLOWS:

1, This casement is soley for the general purposes of construction and laying and thereafter using, operating, inspecting, maintaining,
repairing, replacing or removing water pipeline and any necessary appurtenances thereto over, across, and through the real estate described
above; and,

2. Once such water pipeline and any necessary appurtenances thereto are installed and operating, then this easement (except the general
rights of ingress and egress) shall be automatically reduced in scope to a width of thirty feet, the centerline of which shall be the water
pipeline and any necessary appurtenances thereto,

It is agreed that, during the period of initial construction, no crop damage will be paid by the District. The District, its successors and
assigns, hereby promise to maintain such water pipeline and any necessary appurtenances in good repair so that damage to adjacent real
estate of Owner(s), if any damage there be, will be kept to a minimum. Said pipeline shall be placed within 30 feet from and adjacent to
existing road right-of-way; provided, however, that grantee may deviate from said course to avoid natural and/or man-made barriers or
obstructions.

The District further agrees:

1. To repair, or pay to repair, any tile lines and fences injured or destroyed during construction and in the course of maintenance thereafter.
2. To pay for any crops damaged or destroyed in the course of maintenance beginning one year from the date of initial construction.

3. As long as there is adequate water available, the Owner or successor Owners of the above described property may, by paying the current
membership fee and other associated costs at that time, avail themselves to any number of water service hook-ups.

Executed this ____ day of ________, 19__.

INDIVIDUAL

State of County, ss:

On this day of 19 , before me, the undersigned Notary Public in and for the aforesaid County and State,
personally appeared

to me known to be the same and identical person(s) who executed the within and foregoing instrument, and acknowledge that they executed
the same as their voluntary act and deed.

Notary Public in and for Said County and State

CORPORATE

State of County, ss:

On this ____ day of ________ 19__ , before me, the undersigned Notary Public in and for the aforesaid County and State,
personally appeared and to me personally known,
who being by me duly sworn, did say that they are the and

of said corporation; that (no seal has been procured by the said) (the seal affixed thereto is the seal of said) corporation: that said instrument
was signed and sealed on behalf of said corporation by authority of its Board of Directors; and that the said

and as such officers, acknowledged the execution of said
instrument to be the voluntary act and deed of said corporation, by it and by them voluntarily executed.

Notary Public in and for Said County and State</text>
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                <text>1997 Xenia Rural Water File (Customer Sign-up Packet)</text>
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                <text>Xenia Rural Water District; Xenia Rural Water; Xenia; Rural Water; Dana, Iowa; Greene County, Iowa; customer sign-up packet; Water User's Agreement; membership fee; Consider the Cost; well system cost; water consumption; rate sheet; NW Trans., Boone East Rate; positive disconnect; cross-connection; easement responsibilities; tile repair; Limited Easement; FmHA; USDA Rural Development; 357A; western Boone County; eastern Greene County; Woodward, Iowa</text>
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                <text>Xenia's packet for potential customers in western Boone and eastern Greene counties, with a cover letter, Water User's Agreement terms, cost comparison ("Figures for 1997"), rate table, positive disconnect specifications, easement responsibilities, tile repair diagram and blank Limited Easement. The packet is undated; 1997 comes from the cost sheet. The cover letter's list includes Expansion Sign-up Information sheets and a Water User's Agreement. Text showing through the cover letter suggests the first sign-up page was once stacked against it, and it is not in this folder. Eight sheets.</text>
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              <text>XENIA RURAL WATER DISTRICT [letterhead]

October 9, 2009

City of Dana
405 19th N
Dana, IA 50107

Re: Ordinance Requiring Mandatory Connection to City Water Connection

Dear City Clerk

Recently, Xenia Rural Water District has begun a review of documents on file. One ordinance that is
referenced in the franchise documents of your city is the Ordinance Requiring Mandatory Connection to

City Water System. This Ordinance is often passed after the Franchise Ordinance is finalized and has not
always been sent on to Xenia.

It is important for our records that we have a copy of the mandatory connection ordinance described
above. I have included a copy of an ordinance from one of our franchise communities so that you may
use it for reference in locating the document.

Please feel free to call me with any questions. I appreciate your cooperation and timely completion of
this request.

Very truly yours,

[signature: Wende Shires]
Wende Shires
Executive Assistant

Enclosure (1)

2398 141st Street • P.O. Box 39 • Bouton, Iowa 50039-0039
Office: 515-676-2117 • Fax: 515-676-2208 • WATS: 888-355-2619
www.xeniawater.org • X.R.W.D. is an equal opportunity provider and employer</text>
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              <text>CITY OF DANA

202 E MAIN
GRAND JCT., IA 50107

515-738-5744

MAY 28, 1999

XENIA RURAL WATER DISTRICT
BOX 459
WOODWARD, IA 50276

I am sending a copy of the electric bill for the water system
in Dana. I have paid this bill and all others due since January.
I believe you should reimburse all these electric bills. You have
not transfered this account to your company. Please contact
Alliant Energy and have this sent to you. Thank you.

Sincerely,

Janice Gilley
City Clerk</text>
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                <text>Letter from City Clerk Janice Gilley to Xenia enclosing an electric bill for the water system. She says she has paid this and all others due since January, believes Xenia should reimburse them, and asks Xenia to have the account transferred. Unsigned copy. No reply is in the folder.</text>
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              <text>ORDINANCE NO. ____ [blank sample form]
AN ORDINANCE REQUIRING MANDATORY CONNECTION TO CITY WATER SYSTEM

Be it enacted by the City Council of the City of ________,
Iowa:

SECTION 1. Definitions:

a. The words, “habitable dwelling", shall mean any
building, trailer house, or other structure in which a person or
persons have lived or reside with the past three years.

b. The word, "business", shall mean any activity for
profit which is or was conducted with a building, trailer house
or other structure within the past three years.

c. The words, “other public or private buildings",
shall include, but is not limited to, churches, schools, and

other buildings owned or operated by any governmental
subdivision.

SECTION 2. Mandatory Connection Required:

From the effective date of this Ordinance, the owner of
every real property lot, or subdivision thereof, upon which is
located a habitable dwelling, business building, or other public
or private building, shall, within 6 months of the time a city
water main is constructed adjacent to said property, connect said
dwelling, business or other building to said city water main.

SECTION 3. Violation:

Failure to comply with this Ordinance shall constitute

a simple misdemeanor. Each day of non-compliance with this
Ordinance shall constitute a separate offence.

SECTION 4. Repealer Clause:

All Ordinances or parts of Ordinances in conflict with
the provisions of this Ordinance are hereby repealed.

SECTION 5. Severability Clause:

If any section, provision or part of this Ordinance
shall be judged invalid and unconstitutional, such adjudication
shall not affect the validity of the Ordinance as a whole or any

section, provision or part thereof not adjudged invalid or
unconstitutional.

[page 2, turned at an angle on the scan]

SECTION 6. When Effective:

This Ordinance shall be in effect from and after its final passage, approval and publication as provided by law.

PASSED and APPROVED this ____ day of ________,

________ Mayor
of the City of ________, Iowa

Attest:
________, City Clerk</text>
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              <text>XENIA RURAL WATER DISTRICT [letterhead]

June 9, 1998

City of Dana
Janice Gilley
202 Main St.
Dana, IA 50107-9540

Dear Ms. Gilley:
Please have the City Council pass the enclosed resolution to enable us to serve the rural
residents within the two mile area. We apologize for the delay of receipt of this

document, as we thought it was include with the the Franchise Agreement.

If you have any question, please feel free to contact the office.

Sincerely,

[signature: Daniel A. Miller]
Dan Miller
General Manager

119 Main Street • P.O. Box 459 • Woodward, Iowa 50276
Office: 515-438-2944 • Fax: 515-438-4352

[page 2]

RESOLUTION NO. ____ [blank form as sent by Xenia]

A RESOLUTION AUTHORIZING XENIA RURAL WATER DISTRICT TO
CONSTRUCT, OPERATE AND MAINTAIN A WATER DISTRIBUTION SYSTEM
WITHIN TWO MILES OF THE CITY OF DANA, GREENE COUNTY, IOWA.

WHEREAS, the Xenia Rural Water District intends to construct, operate

and maintain a water distribution system generally described as the North West
Distribution Project.

WHEREAS, the North West Distribution Project will have some of its
transmission main and service connections within two miles of the city limits of the City of
Dana, Greene County, Iowa,

WHEREAS, Xenia Rural Water District has submitted a water service plan
in accordance with Section 357A.2, Code of Iowa, including areas within the two mile
area of the City of Dana, and,

WHEREAS, the City of Dana deems such construction to be in the best
interest of the City and its residents.

NOW THEREFORE BE IT RESOLVED that the City of Dana, Greene
County, Iowa, hereby consents to the construction, operation and maintenance of a water
distribution system to serve the customer located within a two mile radius of the city limits
of the City of Dana.

PASSED and APPROVED this ____ day of ________,

Mayor,
of the City of Dana, Iowa

Attest:

City Clerk

twores-nw</text>
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                <text>Xenia Rural Water District; Xenia Rural Water; Xenia; Rural Water; Dana, Iowa; Greene County, Iowa; Resolution 98-2; two-mile resolution; North West Distribution Project; Code of Iowa 357A.2; Franchise Agreement; Dan Miller; Daniel A. Miller; Janice Gilley</text>
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                <text>Letter from General Manager Dan Miller asking the City Council to pass the enclosed resolution so Xenia can serve rural residents within two miles of Dana, with the blank resolution form. The council adopted it as Resolution 98-2 on August 5, 1998. Two pages.</text>
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              <text>8. PROJECT IMPACT

The proposed project will provide an opportunity for six cities, a county residential facility, and
eighty rural households to have a long-term, safe, sanitary, and reliable water supply. This
joint project for a regional treatment facility will be a more cost-effective approach than for
each community to build its own treatment facility. The rural water provider will contribute to
the construction of the treatment plant with a capacity charge, and then purchase water from
the facility to distribute to the other participating cities. The project is targeted towards
smaller communities with immediate water treatment and supply problems, and according to
the engineering reports, is designed to have the treatment and transmission capacity for the
participating cities plus additional communities who may want to connect to the system in the
future. Peak treatment capacity will be 6.8 MGD, which includes 4.6 MGD for the provider
city and 2.2 MGD for the Xenia Rural Water District participants. This will allow Xenia
participation to grow into the year 2025.

CDBG funding is vital for the project to be implemented. With CDBG funds, monthly
residential rates will average from $ 14.50 to $ 34.33 per household, based on 4,000 gallons
per month. Without CDBG funds, the rates will average $ 10 to $ 20 higher per month, with
the smaller cities being in excess of $ 50 per month. These rates would place a burden on LMI
households. Three of the cities have LMI percentages above 70 percent. These small cities also
do not have the bonding capacity to build invididual treatment facilites (See “Financial
Information for Capital Improvements Project “ form for each participant).

Should CDBG funding not be obtained, the provider city will not construct the extra capacity
required for the rural water service, which will require the cities to pursue other alternatives at
a greater cost.

The project will have no direct environmental impact and will mostly take place within
easements on private, rural property, or county right-of-way. The treatment plant and well will
be built within the city limits of one community. Two storage facilities will likely be built on
rural property which will be acquired. No persons or businesses will be displaced as a result of
this project.

The availability of a safe, reliable source of water will provide the potential for more
residential, industrial, and commercial development within the participating jurisdictions. The
project will be the first step for more potential expansion of the rural water system to other
cities and rural users in the two counties.

The applicants, through their grant administrator, will endeavor to solicit MBE/WBE
contractors through the state clearinghouses. Plans and specifications will be sent to the
appropriate clearinghouses to encourage such businesses to participate in the project.

[page 2]

[top of sheet cut off; ?: "DANA"]

9. FINANCIAL INFORMATION FOR CAPITAL IMPROVEMENTS PROJECTS
All projects involving capital improvements must complete this form.

A. User Fees and Revenues (Water | Sewer)
Number of Residential Users: 25 | NA
Average Monthly Residential Bill: $31 | NA
Projected Average Monthly Bill Without CDBG Funds: $44.22 | NA
Projected Average Monthly Bill With CDBG Funds: $31.82 | NA
Date of Last Rate Increase (month and year): 7-94

B. Other Capital Improvements Projects
Briefly describe the community's most recent capital improvements project(s) and associated costs. Describe any project for which the community has established a capital improvements fund and provide the current balance of that fund:
[left blank]

C. Bonds
Existing Tax Levy: $8.1
General Obligation Bonding Capacity: $88,704
Current General Obligation Bonded Indebtedness: $0
Revenue Bonded Indebtedness: $0
Other Indebtedness (specify GE loan): $50,000
Annual Debt Retirement for Outstanding Bonds or Loans: $4,500
Issue Date [blank]   Issue Amount [blank]   Year of Retirement 2005

D. Available General Revenue Reserves: $10,000
Narrative: $8,000 of this will be used for water project.

19</text>
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                <text>1995-1996 Xenia Rural Water File (CDBG Application Pages)</text>
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                <text>Xenia Rural Water District; Xenia Rural Water; Xenia; Rural Water; Dana, Iowa; Greene County, Iowa; Community Development Block Grant; CDBG; application; project impact; regional treatment facility; six cities; capacity charge; low and moderate income; LMI; capital improvements; GE loan; G.E. Capital; bonding capacity; revenue reserves</text>
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              <text>XENIA RURAL WATER DISTRICT [letterhead]

February 5, 1999

City of Dana

202 Main Street

Dana, IA 50107-9540

Dear City Council:

We have completed the transmission main to the city and have connected the new water
source. I have enclosed the breakdown of Dana’s connection fee showing how the funds

have been appropriated for this project.

Xenia would like the $8,205 of cash contribution at the cities earliest convenience. If you
have any questions regarding this project, please give me a call.

Sincerely,

[signature: Daniel A. Miller]
Daniel A. Miller
Executive Director

Enc.

[handwritten: Paid 3000.00 3-19-99]

119 Main Street • P.O. Box 459 • Woodward, Iowa 50276
Office: 515-438-2944 • Fax: 515-438-4352

[page 2]

DANA’S CONNECTION FEE

$303,805 Connection Fee

-$ 71,000 C.D.B.G. Grant

-$ 8,205 Cash Contribution

-$174,600 U.S.D.A. Rural Development Grant
$ 50,000 *

* The consumer rate table has been structured for repayment of the
loan financed with U.S.D.A. Rural Development

INTEREST $50,000 @ 4.5% for 40 years
(Assuming poverty level MHI can
can be reached)
-38 years amortized
-2 years interest only</text>
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                <text>Xenia Rural Water District; Xenia Rural Water; Xenia; Rural Water; Dana, Iowa; Greene County, Iowa; connection fee; $303,805; CDBG; USDA Rural Development; $8,205; cash contribution; $50,000 loan; transmission main; Daniel A. Miller; Dan Miller</text>
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                <text>Letter from Executive Director Daniel A. Miller reporting the transmission main complete and the new source connected, and asking for the $8,205 cash contribution. A handwritten note reads "Paid 3000.00 3-19-99." The enclosed breakdown shows a $303,805 connection fee, less $71,000 CDBG, $8,205 cash and a $174,600 USDA grant, leaving a $50,000 USDA loan at 4.5% for 40 years, to be repaid through the consumer rate table. Two pages.</text>
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              <text>(FMHA Approved)   WATER USER'S AGREEMENT   No. ______
[unused form; name, address, phone, property description, number, date and signature are blank. The amounts in paragraphs 2 and 8 are handwritten.]

Name:
Address:
Phone:
Property Description:

THIS AGREEMENT is made between Xenia Rural Water District, an Iowa non-profit corporation, (the "District"), and the person(s), firm or corporation first named above, as a Participating Member of the District, (the "Member"), and PROVIDES AS FOLLOWS:

1. At the location shown above, the District shall provide the Member as soon as practicable with such quantity of water for domestic and farm purposes as the Member presently desires in connection with the Member's use or occupancy of such real estate, subject to the conditions and limitations stated below.

2. Immediately upon execution of this Agreement, the Member shall convey to the District in consideration of this Agreement and without further payment by the District an easement in the form and of a nature requested by the District concerning the real estate described above as may be required for the purpose of installing, maintaining, removing and relocating water lines and related equipment in connection with its system, and shall pay the District upon such execution a non-refundable fee of $ 300.00 to connect to the District's planned water distribution system.

3. Beginning from the District's final delivery point upon the real estate described above as determined by the District's Engineers, the Member shall have a qualified person install and maintain, at the Member's sole expense, appropriate water service piping and apparatus to meet the Member's present water needs; provided, however, that such shall not be connected in any manner to any source of water other than the District's distribution system.

4. The District shall provide at or near the final delivery point and at District expense an appropriate cut-off valve and water meter on the District's distribution system. Such cut-off valve and water meter shall be and remain the sole property of the District and shall be for its exclusive use. The District shall have a right of access to the cut-off valve, water meter and distribution line.

5. If the Member fails or refuses after having signed this Agreement, once water becomes available from the District, to connect to the final delivery point or to pay each month the minimum water use rate, or in the event of the cancellation or involuntary termination of the membership of the Member, then the Member shall immediately make a lump sum payment to the District equal to the average initial project development cost per member based upon the total initial cost of the District's water supply, treatment, transmission and distribution system, and calculated as of the date of the Member's failure to pay, or his cancellation or involuntary termination of membership; provided, however, that the District's Board of Directors may adopt from time to time such rules or regulations which may reduce the required payment the Member must make upon refusal to pay the monthly minimum use rate or in the event of cancellation or involuntary termination of his membership.

6. The Member may not allow any other household, firm or corporation to receive water supplied to the Member by the District without prior written approval from the District's Board of Directors.

7. If the District should declare that a water shortage exists at any location within the District's distribution system, the Member hereby consents to an allocation of water by the District's Board of Directors on such basis as the Directors may deem equitable in consideration of the following order of priority uses: basic and necessary domestic purposes; livestock watering purposes; lawn and garden purposes; all other purposes.

8. The minimum monthly charge to the Member for each month water is available to the Member from the District shall initially be $35.00 + TAX; however, the District may, from time to time, in its sole and absolute discretion change such minimum monthly charge. The minimum monthly charge to the Member provided for in this paragraph shall, subject to the provisions of paragraph 7, entitle the Member to receive during each such month for which such charge is assessed a maximum of 2,000 gallons of water from the District. The Member shall pay the District for the Member's use of water in excess of 2,000 gallons during any month an amount determined by the District based on such rates for said water usage may be, from time to time, established by the District in its sole and absolute discretion. The time or times when the payment of the charges and amounts owed by the Member to the District under the terms of this paragraph become due and payable to the District shall be determined by the District, from time to time, in its sole and absolute discretion.

9. Due to presently limited system design capacity, the District does not guarantee to any Member that unplanned future increases in water demand will be met.

10. In addition to the remedies provided in paragraph 5, if the Member fails to fully and timely pay all water charges duly imposed, then and without further notice to the Member, any or all remedies may be applied by the District:
a. Non-payment within ten (10) days from the due date will subject the Member to a penalty of up to ten percent (10%) of the sum then due and unpaid;
b. Non-payment within thirty (30) days from the due date will automatically result in a shutoff of water by the District to the Member;
c. Non-payment within sixty (60) days from the due date shall, at the sole option of the Board of Directors of the District, result in termination of membership in the District of the member; and,
d. Such other legal and equitable remedies as allowed by law may be pursued by the District.

11. The Member further agrees to comply with the terms and provisions of the Water User's Agreement as may be from time to time amended, and further agrees to comply with the Articles of Incorporation, By-Laws and Rules and Regulations of the District, as may from time to time amended.

12. The Member may, at any time after connecting to the final delivery point and after water becomes available from the District, elect to terminate this Agreement, and such termination shall become effective only after making a lump sum payment to the District equal to the average initial project development cost per member based upon the total initial cost of the District's water supply, treatment, transmission and distribution system, which is calculated as of the date of the Member's election to terminate, and the Member shall be required to make such payment upon termination; provided, however, that the District's Board of Directors may adopt from time to time such rules and regulations which may reduce the required payment the Member must make upon voluntary termination.

SIGNED this ______ day of ____________, 19____.

XENIA RURAL WATER DISTRICT      ____________________ Participating Member</text>
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                <text>Xenia folder, City Hall</text>
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            </elementTextContainer>
          </element>
          <element elementId="42">
            <name>Format</name>
            <description>The file format, physical medium, or dimensions of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="6578">
                <text>Printed legal-size form with handwritten amounts</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="6579">
                <text>Xenia Rural Water District; Xenia Rural Water; Xenia; Rural Water; Water User's Agreement; FMHA; membership fee; connection fee; minimum monthly charge; easement; lump sum payment; termination; water shortage; Dana, Iowa; Greene County, Iowa</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="6580">
                <text>Blank Water User's Agreement between Xenia Rural Water District and a member, with handwritten terms of a $300.00 non-refundable connection fee and a $35.00 + tax monthly minimum for up to 2,000 gallons. A member who cancels, is terminated or leaves owes a lump sum equal to the average initial project cost per member, unless the board reduces it. The form is undated; it is filed under 1997 with the customer sign-up packet, whose cover letter lists a Water User's Agreement.</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="6582">
                <text>City of Dana, Iowa</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="6583">
                <text>City of Dana, Iowa</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="6584">
                <text>City of Dana, Iowa</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="6585">
                <text>American English</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="51">
            <name>Type</name>
            <description>The nature or genre of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="6586">
                <text>Public government records</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="38">
            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
            <elementTextContainer>
              <elementText elementTextId="6587">
                <text>Dana, Greene County, Iowa</text>
              </elementText>
            </elementTextContainer>
          </element>
        </elementContainer>
      </elementSet>
    </elementSetContainer>
    <tagContainer>
      <tag tagId="34">
        <name>1997</name>
      </tag>
      <tag tagId="70">
        <name>xenia</name>
      </tag>
    </tagContainer>
  </item>
</itemContainer>
