Fillable Fy 19 Landscape Partnership Application Form (Commonwealth of Massachusetts)

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Fy 19 Landscape Partnership Application Form (Commonwealth of Massachusetts)

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Landscape Partnership Grant Program
APPLICATION FORM – FY2019
Please print double-sided
1. APPLICANT INFORMATION
Project name: ______________________________________________________________________
Project partners & contact information
All projects must have at least two project partners with a significant investment, representing at least two of
the following categories: municipal conservation commissions, water departments (or selectmen acting as such);
non-profit public water suppliers; non-profit 501(c)(3) organizations whose primary purpose includes land
conservation, environmental protection, environmental education, or outdoor recreation; government land agencies,
including the Massachusetts Departments of Conservation and Recreation, Agricultural Resources, or Fish and Game,
or US Department of the Interior or US Department of Agriculture, or the Massachusetts Department of
Transportation.
Partner type Project partner Contact name
Contact
(address, phone, email)
Lead
–
this person will serve as the point of contact for this application, and will be responsible for ensuring
all
partners complete their obligations
Partner 2
Partner 3
Partner 4
Partner
5
Municipal project partners: attach a letter from the municipal Chief Executive Officer (typically chair of
selectboard, mayor, or city/town administrator/manager) indicating that the project contact is authorized to
apply for funds through the Landscape Partnership Grant program.
2. PROJECT DETAILS
Projects must include at least 500 acres of contiguous land. They can include multiple tracts or ownerships, and can include
additional acres that are contiguous via other permanently protected land (does not include Chapter 61 land).
Can this project be completed in FY 20 (July 1, 2019 – June 30, 2020)?
No Yes, if necessary Yes, preferred
Can this project be completed in one fiscal year?
Project can be completed in one fiscal year.
Project can be completed in two fiscal years.
If project needs to be completed in two fiscal years, how much grant funding is needed in
FY 2019________ FY 2020_____________
Total acres: ___________ Number of parcels: _____________
Project location (municipality/ies)
________________________________________________________________________________
__________________________________________________________________________
Will this project include forest inventory and carbon credit sale preparation for forest carbon market
program?
Yes No
If yes, describe the work proposed:______________________________________________
_______________________________________________
_______________________________________________
Will this project include the development of a municipal park or playground (towns with a population of
6,000 or below only)?
Yes No
If yes, describe the work proposed:______________________________________________
_______________________________________________
_______________________________________________
Attach a detailed proposal and budget, including acquisition, design, and construction costs. If requesting
funding to acquire a property on which to construct a park or playground, complete a parcel information
page.
Will this project include the construction of a wildlife passage under or over a road?
Yes No
If yes, describe the work proposed:______________________________________________
__________________________________________________________________________
__________________________________________________________________________
____ ______________________________________________________________________
Who will complete this work? _______________________________________________
When will this work be completed? _______________________________________________
Project budget: _______________________________________________
Funding secured? _______________________________________________
Does this project abut already protected open space (at least 100+ acres) or will it serve as a potential
catalyst for the conservation of 100+ adjacent acres beyond the proposed Landscape Partnership project?
Yes No
If yes, how many acres _______________________________________________________
Provide additional information and wider area map(s) of the existing protected open space or of the
unprotected tracts of lands that this project will serve as a catalyst to protect.
Is the road segment where the passage is proposed classified as likely to provide a significant improvement in
habitat connectivity? (see map here: http://arcg.is/1ALdyj7).
To receive credit, land on either side of the road proposed for a crossing must be already permanently
protected, or protected as part of the proposed project.
Regional Road Barrier Category: A
B
C
D
E
Not classified
Note: To receive credit, crossings located in Hampden, Hampshire, Franklin, or Berkshire
counties must be categories A or B. Crossings located in Worcester County and east must be
categories A, B, or C.
Local Road Barrier Category: A
B
C
D
E
Not classified
Note: To receive credit, crossings must be categories A, B, or C.
Applicants are encouraged to review planned bridge and culvert work scheduled by MassDOT (see here:
(https://www.mass.gov/service-details/massdot-project
-info) and local departments of public works, and seek
to coordinate with these entities. A letter from MassDOT or the DPW committing to completing the work
in a manner and timeliness that will provide the desired habitat improvements must be included in the
application.
Attach a detailed map showing the location of the proposed passage. A letter from MassDOT or the DPW
committing to a timeline of work and design that will provide the desired habitat improvements must be
included in the application.
Will this project include the replacement of an absent, failing, or inadequate stream culvert or bridge with
one that provides good aquatic connectivity?
Yes No
If yes, describe the work proposed:______________________________________________
________________________________________________________________________
________________________________________________________________________
Who will complete this work? _______________________________________________
When will this work be completed? _______________________________________________
Project budget: _______________________________________________
Funding secured? _______________________________________________
Attach a detailed map showing the location of the proposed culvert or bridge.
Project description
A narrative description of your project will be used to evaluate the overall scope and quality of your
proposed project. The questions in subsequent application sections cover standard metrics of natural
resource values, such as Biomap2 and soils classification. The narrative is an opportunity to discuss the
importance and quality of the project not captured by these measures. Attach a description of not more
than four pages that addresses the following:
- Role of each project partner
- Interests to be acquired for each parcel
- Anticipated use of each parcel
- Location and type of public access
- Project timeline
- Why this project should be funded by this grant progr
am. How does it stretch partners beyond what
they would normally do?
- Ecological characteristics and natural resources of the project, as a whole, and each constituent part.
How are they threatened?
- How the project will protect and support natural resource economies
- Importance of the project to climate change adaptation and resilience for wildlife habitat.
- How the project furthers the goals of the Municipal Vulnerability Preparedness Program for the
communities. Applicants are encouraged to propose preservation of forested land that would serve
as natural mitigations for impacts of climate change such as carbon sequestration, flood and
stormwater risk mitigation, and drinking water supply preservation.
- Long-term stewardship plan
- Local demand for park or playground, if requesting funding
- Wildlife passage, stream culvert, or bridge construction that will provide habitat connectivity
- Connectivity to existing protected open space or the potential for future conservation efforts
- Other sources of funding you have or are seeking
- Any additional project partners that are contributing in ways other than acquiring property
- How the applicants address land stewardship on exist
ing municipal and 501(c)3 non-profit land.
Attach documentation of such project(s) to the application (may be in addition to the four page
limit).
- For municipality partners that have signed on the Community Compact Agreement, include a
description of related best practices on land and open space conservation.
Project details
Complete a parcel information sheet for each parcel or project component. A single parcel information
sheet may be used in instances where one partner is acquiring the same interest in multiple
adjacent/subdivided lots currently held under a single ownership.
Parcel Information Sheet Parcel/component #
___
Complete a parcel information sheet for each parcel or project component. A single parcel information
sheet may be used in instances where one partner is acquiring the same interest in multiple adjacent/subdivided
lots currently held under a single ownership.
Municipality: ______________________________________ Acres: _____________
Assessor’s map/lot number: ___________________________________________________
Upland Acreage: ______________________ Building Lots: ________________________
Wetland Acreage:_____________________
Current owner: ___________________________________________________________
Address: ____________________________________________________________
Project partner: ____________________________________________________________
Interest to be acquired: Fee CR APR WPR Multiple interests
If multiple interests, describe: ____________________________________________
____________________________________________
2
nd
project partner (
if applicable): ________________________________________________
Interest to be acquired: Fee CR APR WPR Multiple interests
If multiple interests, describe: ____________________________________________
____________________________________________
Acquisition and funding details
Appraisal Report #1
Appraisal Report #2 (Recommende
d, if land valued at
over $750,000)
Interest
Interest
Valuation
$
Valuation
$
Appraiser
Appraiser
Valuation Date
Valuation Date
Acquisition details:
Negotiated Sale:
Yes No
Do you have a Purchase & Sales Agreement or Agreed Price? Yes No
If yes, amount: $____________________
Have you conducted a title examination?* Yes No
Is clear title available? Yes No Don’t know
If no, is an eminent domain taking anticipated? Yes No
If yes, proposed pro tanto award amount: $____________________
*All parcels must have certified clear title as a condition of reimbursement. If clear title is not available, an acquisition by
friendly taking (eminent domain) process may be used to clear the title. Applicants are advised to conduct title research well
in advance of anticipated closing date, as title problems can complicate and delay acquisition.
Funding request:
Only eligible costs for which appropriate documentation is provided will be eligible for reimbursement. Costs incurred prior
to contract or ISA execution or completion of a capital allocation will not be funded. Federal partners are not eligible to
receive reimbursement. See section 2F in BID for eligible expenditures.
Estimated cost, this parcel/interest: $
Funding request, this parcel/interest: $
For municipal acquisitions:
Do you have town meeting vote/city council approval? Yes No
If not, what is the date for the vote? ____________________________
Note: project must have municipal authorization by December 31, 2018 for FY19
awards and by December 31, 2019 for FY 20 awards. Attach a copy of the vote, or draft language.
Parcel details:
Is there a recent survey available for the parcel? Yes No
Properties lacking recent surveys will be required to complete one as a condition of award payment.
Zoning: ____________________________________________________________________
Present/past use: _____________________________________________________________
__________________________________________________________________________
Is the property currently enrolled in:
Chapter 61or 61A Forest Stewardship Program Forest or Farm Viability
program
Will active forest management or agriculture continue or begin after the acquisition?
Yes No
Proposed use: _______________________________________________________________
__________________________________________________________________________
Are there structures on the parcel? Yes No
For fee acquisitions only: if yes, list structures, estimated value, current and planned use.
This program is
intended to preserve undeveloped land, not to purchase buildings. Buildings not intended to serve conservation purposes are
not eligible for grant funding; their value should be subtracted from the subject property.
____________________________________________________________________________
Will public access be allowed on this parcel? Yes No
Will hunting be allowed on this parcel? Yes No
If public access will be allowed:
Does property have frontage on a street? Yes No
Name of street(s):_____________________________________________________
If no street access, describe how the public can access the property:
_____________________________________________________________________________
_____________________________________________________________________________
Is this parcel located in one of the following areas designated by the Executive Office of Housing and
Economic Development in the South Coast Rail Corridor Plan, the I-495/MetroWest Development
Compact Plan, Merrimack Valley Land Use Priority Plan, or other regional plan as they become available?
Priority Development Area (PDA) Priority Preservation Area (PPA)
Neither No plan available
3. PROJECT QUALITY
Please provide supporting documentation.
Landscape conservation:
Total project area: ____________acres
How much permanently protected open space does the project directly abut?
___________ acres
Biodiversity and resource protection:
How many acres of the project lie within MA Natural Heritage and Endangered Species
Program (MNHESP) BioMap2 Core Habitat?
_______________ acres
How many acres lie within MNHESP BioMap2 Critical Natural Landscape?
_______________ acres
Each property location has been assigned an average climate resiliency score to identify
the importance of the site for climate change adaptation, as defined by The Nature
Conservancy’s Resilient Land map - http://maps.tnc.org/resilientland/. What is the average
resilient score for each the property location in the project?
Parcel #1_____ Parcel #2_____ Parcel #3_____ Parcel #4_____ Parcel #5 _____
Additional Parcels__________________________________________________
Water resources:
How many acres are located within 500 feet of the ocean, a lake, pond, river, stream, or
wetland?
_______________ acres
How many acres are located within a drinking water supply area for existing or planned
public water supplies (Zone 1or II, Zone A or B), or Interim Wellhead Protection Area, or,
are located over a sole-source, medium-, or high-yield aquifer?
_______________ acres
If significant public drinking water supply lands are protected, a letter from the water
supplier benefiting from this protection that explains how this project will help make this
water supply more resilient to the impact of climate change (increased flooding,
stormwater and droughts) may benefit the rating points for the climate change category.
List aquifer or Public Water System ID# (this information can be found at this website -
https://www.mass.gov/service-details/public-water-supplier-document-search:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Working lands:
How many acres of the project, including match parcels, are currently actively managed
commercially for forest or agricultural products (forests: using a licensed forester)?
_______________ acres
How many acres of the project, including match parcels, will be actively commercially
managed for forest or agricultural products, after project completion (forests: using a
licensed forester)?
_______________ acres
How many employees work on actively managed parcels, including outdoor recreation
businesses?
Currently: ____________ Full-time equivalent (FTE) employees
Estimated, after project completion: ________________
FTE employees
How many acres of prime agricultural or prime forest soils will be actively managed by this
project? If this is a significant amount of production, explain how this could improve the
food and forest product security for nearby communities.
Recreational opportunities:
What public recreational opportunities will the project provide? Check all that apply.
Recreational opportunities will be verified by DCS during the site visit. (Reasonable access for trail
based and wilderness [applicants are encouraged to allow hunting on at least a portion of the
funded parcels and included in the Conservation Restriction or management plan for fee
acquisitions].)
Trail-based activities (ex. hiking, Nordic skiing)
Wilderness activities (ex. camping, hunting)
Water-based activities (ex. canoeing, swimming, fish
ing, skating)
Educational activities (ex. organized nature walks, trainings, outdoor classroom)
4. BUDGET
A. Proposed budget: Show primary budgeted activities and matching funds. The minimum
match for the project as a whole is 50%, however, individual project components may be
reimbursed at a higher or lower rate. Landowner bargain sales and gifts of property may be
used as part of project partner’s share of funds.
Expense Partner involved
Partner’s
share
EEA share Total cost
Parcel/project component # ___
(
should match Parcel Information Sheet #___)
:
Example: Property acquisition
Town Land Trust
$50,000
$50,000
$100,000
Parcel/component total and
reimbursement request
Parcel/project
component # ___
(
should match Parcel Information Sheet #___)
:
Parcel/component total and
reimbursement request
Parcel/project component # ___
(
should match Parcel Information Sheet #___)
:
Parcel/component total and
reimbursement request
Parcel/project component # ___
(
should match Parcel Information Sheet #___)
:
Parcel/component total and
reimbursement request
Parcel/project
component # ___
(
should match Parcel Information Sheet #___)
:
Parcel/component total and
reimbursement request
Parcel/project component # ___
(should match Parcel Information Sheet #___):
Parcel/component total and
reimbursement request
Municipal park/playground
Component total and
reimbursement request
TOTAL PROJECT COST & FUNDING REQUEST
A. Funding and match sources
List all other sources of funding and indicate their certainty. Sources may include, but are not
limited to, municipal accounts, non-profit fundraising, agency land acquisition fund, federal grants,
landowner bargain sales, or gifts of lands.
Funding source
Project partner
recipient
Amount
Secured or
pending?
Parcel/project component # ___
(
should match Parcel Information Sheet #___)
:
Parcel/project component # ___
(
should match Parcel Information Sheet #___)
:
Parcel/project component # ___
(
should match Parcel Information Sheet #___)
:
Parcel/project component # ___
(
should match Parcel Information Sheet #___)
:
Parcel/project component # ___
(
should
match Parcel Information Sheet #___)
:
Parcel/project component # ___
(
should match Parcel Information Sheet #___)
:
Additional sources of match
Total project funding
secured
Total project funding secured & pending
5. A COMPLETE APPLICATION INCLUDES THE FOLLOWING
DOCUMENTATION:
1. Application form
2. Appraisal reports. Applications lacking the correct number and type of appraisal
reports (certified appraisal report, restricted appraisal report or contracted Realtor’s
Market Analysis) will be disqualified. See Section 2C of the BID for details.
3. Project narrative
4
. Budget details, itemized as anticipated for each project piece
5. Cover letters signed by an authorized signatory for each partner organization authorizing
the project manager to apply for the grant on behalf of the entity, and committing to
complete the project if awarded a grant.
6. Documentation in support of project quality evaluation (e.g., evidence of enrollment
in Ch. 61/61A; forest management plan; documentation of number of people employed;
documentation of planned public drinking water source, etc.)
7. Maps of values and resources protected, proximity to other conservation lands; plot plans
or survey maps. Include the location, acreage, ownership and use of other protected open
space abutting the project. Show current use of adjacent private lands.
8. Draft CR, APR, or WPR documents, or summaries
9. Other state agency review – Include documentation of the value of your project for
rare species and historic value by contacting the following state agencies and requesting
their review:
Massachusetts Natural Heritage and Endangered Species Program
(https://www.mass.gov/orgs/masswildlifes-natural-heritage-endangered-species-
program).
Massachusetts Historical Commission: Send the MHC a PNF
(http://www.sec.state.ma.us/mhc/mhcpdf/pnf.pdf) with a photocopy of the USGS locus
map with the property boundaries clearly indicated, smaller-scale property maps if
available, and a cover letter to include information about any known historic or
archaeological sites. Send this certified mail, return receipt requested, so that you
know when it was received. MHC will review and comment to DCS (and copy the
applicant) within 30 days of receipt. There is no need to telephone or email the
MHC. See these websites for any questions:
http://www.sec.state.ma.us/mhc/mhcpdf/pnfguide.pdf and
http://www.sec.state.ma.us/mhc/mhcrevcom/revcomidx.htm.
10. Documentation of good land stewardship on past EEA-funded, municipal or
501(c)3 nonprofit land(s). Documentation can include a recent survey outlining the
conditions of the trails or land boundaries, a recent baseline documentation report, and/or
photos/documentations of recent conservation projects or outdoor projects was carried
out on the property. Provide a narrative of how your agency will provide stewardship if
your community does not presently own any conservation land. A link to a website that
shows this information can be used, if applicable.
6. SIGNATURES
Applications must be signed by a representative of each partner organization.
I certify that the contents of this application are accurate to the best of my knowledge, and commit to
the role and investment described herein.
Date: __________
Preparer Print Name
_____________________________________________________________________________________
Organization
Date: __________
Project partner Print Name
_____________________________________________________________________________________
Organization
Date: __________
Project partner Print Name
_____________________________________________________________________________________
Organization
Date: __________
Project partner Print Name
_____________________________________________________________________________________
Organization
Date: __________
Project partner Print Name
_____________________________________________________________________________________
Organization
Date: __________
Project partner Print Name
_____________________________________________________________________________________
Organization
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Fy 19 Landscape Partnership Application Form (Commonwealth of Massachusetts)

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Completed 26 July 2020

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