Fillable Fy 20 Land Grant Application Fillable (Commonwealth of Massachusetts)

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Fy 20 Land Grant Application Fillable (Commonwealth of Massachusetts)

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BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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Attachment A: Application Form
Local Acquisitions for Natural Diversity (LAND) Grant Program
APPLICATION FORM – FY 2020
Please print double-sided
1. APPLICANT INFORMATION
Project name:
_________________________________________________________________
Municipality:
____________
Municipal project manager:
This is the person who will be the day-to-day contact for the project and who will represent the
municipality in communication with DCS. Attach authorization from the Chief Executive
Officer identifying the individual named below.
Name: _________________________________________________________________
Affiliation with Municipality: ___________________________________________________
Address at City or Town Hall: ___________________________________________________
___________________________________________________
___________________________________________________
Phone Number: ___________________________________________________
Fax Number: ___________________________________________________
E-mail address: ___________________________________________________
2. PROJECT DETAILS
Municipality:
Population 2010: Population 2000:
Seasonal population (including student population): source of data:
Describe seasonal population:
Housing Choice Initiative
Has your community been designed as a Housing Choice Community? For more
information please visit https://www.mass.gov/housingchoice.
Yes No
Property: (Provide this information directly from the appraisal report)
Acres: ___________ Number of parcels: ____________
Upland Acreage: _________ Building Lots: _____________
Interest municipality will acquire: Fee
Conservation Restriction (CR)
Both fee and CR
If both, describe:
______________________________________________________
______________________________________________________
Parcel information:
County: ______________________________
Watershed: ____________________________
Assessor’s map/lot number:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Current owner(s)________________________________________________________
Access:
Does property have frontage on a street? Yes
No
If yes, list street(s):
_________________________________________________________________
If no, describe how the public can access the property through adjacent landholdings. Grant funds are
used to purchase land for conservation and public passive recreational use. Properties that do not have
suitable public access will not be funded.
Zoning:
Past use(s):
Present use(s):
Proposed use(s):
Are there buildings or structures on the property? Yes No
If yes, list each and indicate current and planned use. The LAND Grant Program is intended to preserve
undeveloped land, not to purchase buildings. Buildings are ineligible for funding. Any buildings proposed
to be kept must serve a legitimate conservation, outdoor education, or public passive recreational use.
Will this project involve the removal of structures? Yes No
3. ACQUISITION AND FUNDING DETAILS
Appraisal Report #1
Appraisal Report #2 (if needed)
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: $ __________
Is Clear Title available?* Yes No
If no, is an eminent domain taking anticipated? Yes No
If yes, proposed pro tanto award amount: $ __________
*If clear title is not available, the applicant may decide to acquire the property by a friendly taking (eminent domain)
process to clear the title. It is best to know if there is a potential title problem as soon as possible since this can
complicate the acquisition process. Land lacking clear title will not be reimbursed.
Can this project be completed next Fiscal Year, FY 2021? (July 1, 2020 – June 30, 2021)
Yes, if necessary Yes, FY 21
Preferred No
Funding request:
Recipients of LAND grant funding are reimbursed after they have expended the total project
cost and submitted proof of payment. Only costs incurred during a grant recipient’s contract
period will be reimbursed. The reimbursement rate is 52-70%, based upon a municipality’s
Equalized Valuation Per Capita. See the DCS website for a list of rates. See section 2E in BID
for eligible expenditures.
List your anticipated expenditures and requested grant amount below.
Reimbursement rate:
Item
Grant request amount
Property acquisition*
$
Recording fees
$
Title certification
$
Survey
$
Total
$
*Grant award amount is based upon the appraised value or agreed upon purchase price, whichever is less.
Will funds from the Community Preservation Act (CPA) be used? Yes No
Will funds from the Cape Cod Land Bank be used? Yes No
Use of CPA or Land Bank funds require the conveyance of a permanent Conservation Restriction (CR),
within the meaning of Ch. 184, to an eligible non-profit organization.
Have you identified an organization willing to hold the CR? Yes No
Name of organization:
_______________________________________________________
Are you using or seeking funds from other sources or partners? Please list:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4. PROJECT DESCRIPTION
Describe in an attachment, not to exceed two pages, the following:
- Description of the property, including natural resource, recreation, historical, educational,
or agricultural values.
- Purpose of acquisition and proposed uses.
- Consistency with Statewide Comprehensive Outdoor Recreation Plan and community
Open Space & Recreation Plan.
- How the project furthers the goals of the community’s Municipal Vulnerability
Preparedness Program.
- How the proposed preservation of forested land would serve as a natural mitigation for
the impacts of climate change, such as carbon sequestration, flood and stormwater risk
mitigation, and drinking water supply preservation.
- Project schedule.
- Consistency with any nearby State Priority Development or Preservation Areas as shown
on the South Coast Rail Corridor Plan or the 495/MetroWest Development Compact
Plan, or other regional plan.
- Description of land stewardship project on past DCS grant or a municipal conservation
land.
- Plans for use of local wood in signage, footbridges, etc.
5. PROJECT QUALITY
Landscape preservation:
How much protected conservation land does this project abut? acres
How much of the adjacent land can this project potentially serve as catalyst for future
conservation efforts? acres
Describe how the subject parcel’s resource value will be impacted by its potential development.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Recreational opportunities:
Municipal Open Space and Recreation Plan (OSRP):
To apply for this grant, the municipality must have an approved OSRP or have submitted
a draft OSRP by the grant application deadline. To be eligible to apply with only a draft, a
municipality must have completed the public participation process.
List the goals, objectives, or action plan items in your current or draft OSRP this project
meets. Attach to your application copies of the relevant pages (not the whole plan).
Goal, objective, or action plan item from current OSRP
Page no.
1
2
3
4
5
6
7
What public recreational opportunities will the project provide?
Check all of the boxes that best describe your project. Clarify in the space below if
necessary. Recreational opportunities will be verified by DCS staff during the site visit. Please
note that additional points will be given to projects that permit hunting and/or propose
accessible trails.
Hunting activities
Trail-based activities (e.g. hiking, Nordic skiing, biking, horseback riding)
Water-based activities (e.g. canoeing, swimming, fishing, skating)
Historic, cultural, or environmental education
Community gardening or other community agriculture
Additional description:
Biodiversity and resource protection:
Portion of the project area that lies within or abuts MA Natural Heritage and Endangered
Species Program BioMap2 designated areas:
Core Habitat: acres
Critical Natural Landscape: acres
Each project 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 the
project location?
____________ SD
Working lands:
Will active forest management or agriculture continue or begin after the acquisition?
Note: agriculture and forestry activities must be compatible with conservation and public use of the
property.
Yes No
If yes, describe planned forestry or farming:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Water resources:
Portion of the property that is 0-300 ft from ocean, lake, pond, river, stream, wetland, OR
within an existing public drinking water supply area (Zone I/II or A/B), OR over a medium-
or high-yield aquifer:
None 1-24% 25-50% >51%
Bonus Points:
Community Compact
Has your community signed a Community Compact?
Yes No
If “yes”, please list the Environmental Best Practices included in it.
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Municipal Vulnerability Program
Is your community an MVP Community?
Yes No
If “yes”, please describe how this application supports a priority implementation project
within your MVP plan.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
6. MUNICIPAL AUTHORIZATION:
Attach a certified copy of the Town Meeting or City Council vote, or draft language. Vote
must conform to sample vote language criteria, available as Attachment D to this
application.
Does this project have town meeting/city council approval? Yes No
If not, what is the scheduled date for the vote?
____________________________
7. OTHER IMPORTANT DOCUMENTATION:
a. USGS topographic map with an outline of the Project boundary. Include the location,
acreage, ownership and use of other public or quasi-public open space abutting, or close to,
the Project on the topographic map. Show current use of adjacent private lands. If
applicable, show proximity to Priority Development and Preservation Areas as shown on
the South Coast Rail Corridor Plan, 495/MetroWest Development Compact Plan, Central
Massachusetts Land Use Priority Plan, Merrimack Valley Regional Plan, Metro North Land
Use Priority Plan, or other regional plan.
b. Plot plan or survey map showing the Project boundary. The Project area must be
shown in enough detail to be legally sufficient to identify the lands to be protected. A
registered survey plan with deed references or assessor’s map with block and lot number
are acceptable.
c. Documentation of Good Land Stewardship – Applicants should submit
documentation of good land stewardship of past DCS grants or municipal conservation
land. The proof of good stewardship should include examples from three different activities
from the following list: stewardship monitoring report on municipal land, invasive species
control, trail building, educational kiosks, recent surveys outlining the condition of trails or
land boundaries, recent baseline documentation reports, and/or forest or land management
plans. Applicants can submit documentation of other land stewardship activities. Photos of
land stewardship activities are encouraged. Provide a narrative of how your community will
steward the land subject to this LAND grant application if your community does not
currently own any conservation land. Links to web sites that show this information can be
used if appropriate.
d. Draft CR – If your project involves the purchase or conveyance of a CR, please
complete a separate CR application and submit a draft restriction along with this
application. The CR application is available at the DCS website at
www.mass.gov/service-details/conservation-restriction-review-program. To obtain
a copy of the Conservation Restriction Handbook, visit the DCS website, or
contact Denise Pires. Submit the draft CR to:
Denise Pires
Executive Office of Energy and Environmental Affairs
100 Cambridge St., Suite 900
Boston, MA 02114
617-626-1011
e. Other state agency review – If it is not possible to include responses in the application
package to DCS, attach a copy of your cover letter requesting their input.
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. If a Conservation Restriction is
part of your project, you must notify and submit it to MHC for review. 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.
If selected for LAND funding, the Applicant will be required to execute the following forms in
order to complete a contract:
LAND Grant Program Project Agreement
Commonwealth Standard Contract
Commonwealth Standard Terms & Conditions
Contractor Authorized Signatory Listing
8. SIGNATURES
Attach municipality’s legal authority to apply for the grant, and the Chief Executive
Officer’s legal authorization to execute contracts. This is a resolution, motion or similar
action that has been duly adopted or passed as an official act of the community’s governing body
that authorizes the filing of the application, including all understandings and assurances
contained therein.
__ Date: __________
Chief Executive Officer Type Official's Name
Conservation Commission members:
Signature
Printed Name
Chair
APPLICATION ATTACHMENTS – use this as a checklist.
1. Municipal CEO’s Authorization of Project Manager
2. Project narrative
3. Maps of values and resources protected, proximity to other conservation lands
4. Documentation of rare species from the MA Natural Heritage and Endangered Species
Program
5. Documentation of historic resources from the MA Historical Commission
6. Appraisal report(s)
7. Draft Conservation Restriction (if applicable)
8. Documentation of good land stewardship on past DCS grant or Municipal Conservation
land. Attach supporting documentation with the application for one or more past
LAND/Self-Help grants or municipally-owned conservation land. Documentation should
include examples from three different activities from the following list: stewardship
monitoring report on municipal land, invasive species control, trail building, educational
kiosks, recent surveys outlining the conditions of trails or land boundaries, recent
baseline documentation reports, and/or forest or land management plans. Applicants can
submit documentation of other land stewardship activities. Photos of land stewardship
activities are encouraged. Provide a narrative of how your community will steward the
land subject to this LAND grant application if your community does not currently own
any conservation land. Links to web sites that show this information may be provided in
place of the above listed information, if appropriate.
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Completed 27 July 2020

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