Cascadia Conservation District is partnering with the WA Department of Natural Resources to bring FREE chipping to your area! Please complete the forms below to get into the program.

Forms 1 and 2 are required to get you on board. Submit them once only. Please submit them by Nov 1.

Forms 3 and 4 are to claim your expenses. Use them repeatedly if necessary. Please submit them by Nov 30.


Please note: All Fields are required.

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values (‘”.$area.”‘, ‘”.$name.”‘, ‘”.$contact_email.”‘, ‘”.$Address.”‘, ‘”.$City.”‘, ‘”.$County.”‘, ‘”.$State.”‘, ‘”.$ZIP.”‘, ‘”.$phone.”‘, ‘”.$acres.”‘, ‘”.$pP2015.”‘, ‘”.$pC2015.”‘, now() )”, ”
))){
echo “Data Recorded … “;
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Database error-
Please Resubmit. It the problem persists, please contact admin@lakewentcheeinfo.com”; }

$subject = ‘Firewise Form Submission’;
$body= “Data Submitted:\nName: ” .$name. “\nAddress: “.$Address. “\nCity: “.$City. “\nCounty: “.$County. “\nState: “.$State. “\nZIP: “.$ZIP. “\nEmail: “.$contact_email . “\nPhone: “.$phone . “\nAcres: “.$acres. “\n2015 Participation: “.$pP2015. “\nCurrent Participation: “.$pC2015. “\nArea: “.$area;
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}
}
} else {
echo “Form not submitted“;
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}else{
echo $msg = ‘Please fill in all fields‘;
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?>



TO COMPLETE REGISTRATION YOU MUST ALSO SUBMIT FORM #2, LANDOWNER PERMISSION =>>

The Property Owner must give permission for this activity on his property.

2016 Fuels Reduction & Chipping Program Landowner Release

The 2016 Fuel Reduction and Chipping Program is a program administered by the Cascadia Conservation District (CCD). The Program is funded by the Washington Department of Natural Resources (WDNR) and subject to the funding thereof. The work will be completed at a 50/50 cost-share to the landowner specific to 2016 Fuels Reduction and Chipping Program.

Work Must Be Completed to Specifications All work must be completed according to written specifications provided. The LANDOWNER is responsible for ensuring completion of the work, whether by contracting independently or performing “do-ityourself” labor.

Eligible Cost Share Contributions In-kind contributions such as “do-it-yourself” labor or contracted work are considered eligible cost share contributions. The LANDOWNER must furnish all necessary equipment for “do-it-yourself” labor. If you have any questions, please contact the CCD BEFORE beginning any work.

The LANDOWNER is able to contract independently, separate from this agreement, to accomplish work. If the LANDOWNER utilizes a contractor, the LANDOWNER is responsible for selecting, entering into a contractual agreement with, and compensating, the contractor. No payment from the WDNR or CCD will be made directly to contractors or to landowners.

Equipment purchases and/or general landscaping practices are not considered eligible contributions. Work not related to the Fuels Reduction and Chipping Program remains ineligible for cost-sharing and is not reimbursable.

Reporting & Eligibility Cost-shared practices must be completed, and the Landowner Release and Time, Activity, and Equipment Reporting Forms, and proof of payment for contracted work must be reported to CCD by the LANDOWNER May 15, 2016 to be eligible for this program. Please note: these DNR funds are only to treat new acreage and cannot be used for maintenance of treatments funded by DNR in the last 10 years. If you have questions about whether your property qualifies please contact Chuck Wytko with DNR at CHARLES.WYTKO@dnr.wa.gov.

Landowner is Responsible for Property Boundaries LANDOWNER is responsible for ensuring that piles and chips are on LANDOWNERs legal property. The WDNR, CCD or any sub-division, agent, contractor or staff thereof are not responsible for any damages sustained as a result of inaccurately marked property boundaries or to LANDOWNERS property.

Property Access LANDOWNER(S) agree to allow CCD and WDNR staff, or persons authorized by CCD and WDNR, access to the property to determine cost-share needs, feasibility, and specifications; to enter the property to complete chipping operations; and to certify practice completion. If LANDOWNER(S) cannot be present on during site assessments or the day of chipping operations, LANDOWNERS hereby grant permission to CCD and WDNR, and persons authorized by CCD and WDNR, to complete the work described above.

Limitation on Liability The LANDOWNER(S) agree to hold harmless the WDNR, CCD or any sub-division, agent, contractor or staff thereof, for damages sustained to persons or property as a result of this agreement. The WDNR or CCD do not make any express or implied warranties. In no event will the WDNR, CCD and/or their agents be liable to you or any other person or entity for any damages whatsoever, including, without limitation, direct, incidental, or indirect damages, special or consequential damages arising out of the services provided hereunder, even if they are foreseeable or you have been advised of the possibility of such damages.

The LANDOWNER(S) consent that the CCD may utilize photographs of the property for the purposes of reporting, verification, illustration, broadcast, or distribution in any manner. Consent is given without further consideration or compensation.

Cancellation If at any time you decide to cancel your application for chipping, you must advise the CCD. In case of cancellation, you, the LANDOWNER, are still responsible for compensating any hired contractors for services performed in a timely manner.

Thank you for your participation in the Fuels Reduction and Chipping Program!

I hereby authorize the above work and necessary assessments to be accomplished on my property and allow the WDNR and CCD authorized representatives and contractors to enter onto my property for purpose of conducting said work. I have reviewed the boundaries of the work and certify that I am the owner of the property on which the work is to be performed.

Please enter your full name in lieu of a signature below and submit the page.

Contact Person: Amanda Levesque Phone/Email: 509-436-1601 or Amandal@cascadiacd.org

You can also download the Permission Form and fax or email it to Amanda Levesque as per the contact details on the form.

Download Permission Form

CCD Fuels Reduction & Chipping Program Time, Activity, and Equipment Reporting Form – PAGE 1 of 2

Incidental Expense Record (In Kind Cash Contributions)

Please submit your claim before Nov 30!

Please record the date and a detailed description of the expense and the total amount. Submit all receipts with this record.

Eligible expenses: saw gas, blade sharpening, tool maintenance, equipment rental, contractor expenses, $0.54/mile for vehicle usage.

Ineligible expenses:

Tool/equipment purchase.


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Maximum file size: 10mb.


CCD Fuels Reduction & Chipping Program Time, Activity, and Equipment Reporting Form – PAGE 2 of 2

Landowner Time Sheet (In-kind Time Contributions)

Please submit your claim before May 30!

Please record each activity separately. If more than one person is working, place total hours worked in the hours column (example: 2 people pile slash for 3 hours each on 3/10/15, enter 6 hours)

Eligible Activities: project related travel time, planning, thinning, pruning, brush removal, piling Ineligible expenses: Tool/equipment purchase.


Acceptable file types: doc,docx,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 10mb.