Kentucky
Department of Fish and Wildlife Resources
Stream and
Wetland Restoration In-Lieu Fee Program
Site Proposal
Form
Please complete
this form as completely as possible and return it to:
The Kentucky
Department of Fish and Wildlife Resources
Environmental Section
Stream and Wetland Restoration Program
#1 Sportsman’s Lane
Frankfort, KY 40601
Fax:
502/564-4519
Questions? Call:
800/852-0942, ext. 328 or 343
I. General Information
1.
Date_____________________
2. Landowner
name ____________________________________________________
3.
Address________________________________________________________
4. Telephone
number and e-mail address____________________________
5. How did you
find out about the Stream and Wetland Restoration Program?
______________________________________________________________________
6. Do you have
neighbors that would be interested in the program?_________________
II. Site Characteristics
1. County
_______________________________________________
2. Stream name
(if known) _________________________________________________
3. Stream size
(width and length)____________________________________________
4. Do you own
both sides of the stream? Yes___ No___ Combination___
5. Do the stream
banks have trees growing on or within 25 feet of them?_____________
6. Brief
description of the problem with the stream.
______________________________________________________________________
To ensure
long-term benefits and protection of the project area, the landowner
must agree to a perpetual conservation easement or deed
restriction. Generally, the easement would pertain only to the
affected stream channel and newly created streamside zone with
planted trees. Ownership of the land protected by a conservation
easement is retained by the landowner. No public access is implied
by entering into a conservation easement unless otherwise stated
within the easement.
KDFWR will
evaluate the information provided on this form and determine if the
property meets the SWRP site criteria. Properties that meet SWRP
criteria are potential project sites that will require a field
assessment before a funding determination can be made. By
completing, signing and returning this form, I give KDFWR permission
to
perform a site
feasibility assessment of the property described above at no cost to
the landowner and at a date and time to be agreed upon by KDFWR and
the landowner.
______________________________________ ______________________
(Signature of landowner)
(Date)
