Family Forest Fish Passage Program Application

1. Application for Fish Passage Barrier Evaluation

The Family Forest Fish Passage Program (FFFPP) is a program for small forest landowners to improve fish passage on their forestlands. If you think you may have a fish barrier and are interested in receiving assistance with replacing this barrier, please complete this application. A fish barrier is any artificial in-stream structure such as a culvert, dam, or road crossing that impedes the free passage of fish. For a full explanation of this program, please refer to FFFPP guidelines that are available on the Small Forest Landowner Office (SFLO) website at www.dnr.wa.gov/fffpp or call 360.902.1404 for assistance.

When the SFLO receives your application, a field representative will contact you to set up a date for a site visit and provide you with a detailed explanation of the program. If it is determined that you do not have a barrier, you will no longer be enrolled in the program.

1. Landowner Information:

Landowner Information: Name:
Company:
Address:

City/Town:
State:
ZIP:
County:
Email Address:
Phone Number:

2. Site Address (if different):

Site Address (if different): Address:
Address 2:
City/Town:
State:
ZIP:
County:

3. County Assessor Parcel No. at Site:

County Assessor Parcel No. at Site:

4. Legal Description

Legal Description 1/4 Section:
Section:
Township:
Range:

5. Forest Practice Application No. (if applicable)

Forest Practice Application No. (if applicable)

6. Number of fish barriers you are applying for:

Number of fish barriers you are applying for:

7. Name of stream:

Name of stream:

8. Tributary to:

Tributary to:

9. Landowner Representative:

Landowner Representative:

10. Telephone Number:

Telephone Number:

11. How did you find out about the program?

How did you find out about the program?

12. Driving directions to site:

Driving directions to site:

13. Comments:

Comments:

14. I choose to enroll in the Family Forest Fish Passage Program and would like to have my potential barrier evaluated for eligibility.

I choose to enroll in the Family Forest Fish Passage Program and would like to have my potential barrier evaluated for eligibility. Yes

15. Landowner Signature:

Landowner Signature:

16. Date:

Date: