Fillable ADOPT-A-SPOT PROGRAM APPLICATION Yes, I want to adopt (City of Augusta)

Fill Online, Printable, Fillable, Blank ADOPT-A-SPOT PROGRAM APPLICATION Yes, I want to adopt (City of Augusta) Form

Use Fill to complete blank online CITY OF AUGUSTA (GA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

ADOPT-A-SPOT PROGRAM APPLICATION Yes, I want to adopt (City of Augusta)

On average this form takes 9 minutes to complete

The ADOPT-A-SPOT PROGRAM APPLICATION Yes, I want to adopt (City of Augusta) form is 2 pages long and contains:

  • 0 signatures
  • 14 check-boxes
  • 30 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Augusta

BROWSE CITY OF AUGUSTA (GA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
KE E P AU G U S T A BE A U T I F U L |
A DI VI SI O N O F EN VI RO N M E NT A L SE RVI C E S
|
ED K E S H A AND E RS O N
PR O G RA M MA N A G ER
535 Telfair Street, Suite 520
Augusta, GA 30901
www.keepaugustabeautiful.com
(706)-312-4125
Keepaugbeautifulvm@augustaga.gov
ADOPT-A-SPOT PROGRAM APPLICATION
Yes, I want to adopt a spot in Augusta, Georgia
I would like to renew my current adopted location. (Please provide Clean-Up Reports and Annual
Agreement.)
Date: ________________
First Name: ________________________ Last Name: _________________________
Address: __________________________________________________
City: _____________________ State: ____________ Zip: __________________
Home Phone: ____________________ Cellphone: _________________
Email: _______________________________________________________
Group Affiliation, If Any: __________________________________________________
If you are a member of a group, are you the group’s spokesperson? Yes No
Name to be placed on Sign: ______________________________
Note: Sign installation will occur up to 60 days AFTER 2 reported cleanups.
I would like to adopt/renew the following location(s) if available. (Please be specific.)
__________________________________________________________________________________________
__________________________________________________________________________________________
___________________________________________________________________________
Signature: _____________________________________ Date: ______________________
KE E P AU G U S T A BE A U T I F U L |
A DI VI S I O N O F ENV I RO N M EN T AL SE R V I C ES
|
ED K E S H A AND E RS O N
PR O G RA M MA N A G ER
535 Telfair Street, Suite 520
Augusta, GA 30901
www.keepaugustabeautiful.com
(706)-312-4125
Keepaugbeautifulvm@augustaga.gov
IMPLEMENTATION PLAN
1. What type of spot are you adopting? Street Park
Traffic Circle Traffic Median
City Owned Lot Other________________
2. What are your plans for your adopt-a-spot? __________________________________
3. Describe the location of your adopt-a-spot (provide a GIS map with location indicated).
a. 1
st
Choice Location _________________________
b. 2
nd
Choice Location _________________________
c. 3
rd
Choice Location __________________________
4. Will you need supplies for your cleanup events? _____________
5. If so, How often will you perform cleanup events? __________________________
6. Will there be planting in your spot? Yes No
REQUIRED FORMS
1. ADOPT-A-SPOT APPLICATION
2. ADOPT-A-SPOT IMPLEMENTATION PLAN
3. GIS MAP OF LOCATION
4. RELEASE,WAIVER, HOLD HARMLESS, & INDEMNITY AGREEMENT (required for each participant)
FOR OFFICE USE ONLY:
Date Application Received: __________
Area Assigned: _________________________
Liability Waiver Attached: [ ] Yes [ ] No
Safety Recommendations Provided: [ ] Yes [ ] No
Application Processed by: ___________
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

ADOPT-A-SPOT PROGRAM APPLICATION Yes, I want to adopt (City of Augusta)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 21 January 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document