Family Forest Fish Passage Program Application

The Family Forest Fish Passage Program assists small forest landowners to improve fish passage on their forestlands by removing artificial, or human-created fish barriers. If you believe you may have a fish barrier and are interested in having the site evaluated, please complete this application. For a full explanation of this program, please refer to Family Forest Fish Passage Program Guidelines (http://www.dnr.wa.gov/Publications/fp_sflo_fffppguidelines.pdf) or call (360) 902-1404 for assistance.

After your application is received, a field representative will contact you to set up a site visit and provide you with a detailed explanation of the program. If the site does not meet the program criteria, your enrollment will be automatically discontinued.

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* Contact Information

Landowner(s):

Company/Corporation name:

Mailing address:

City:

State:

Zip Code:

Home/Business phone:

Cell:

Email:

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* Who will be the main contact for your project?

Landowner

Landowner representative

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* If the landowner is represented by someone other than themselves, please provide their information below

Name:

Phone:

Email:

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* How did you find out about the program?

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* How many acres do you own?

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* Site Location

Address:

City:

State:

Zip Code:

County:

Parcel number:

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* Legal Description

1/4 Section:

Section:

Township:

Range:

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* Forest Practices application number (if applicable)

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* Number of barriers you are applying for

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* Type and amount of barriers

Culvert

Bridge

Dam

Spillway

Puncheon

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* What is the name of the stream the barrier is located on?

Stream:

Tributary of:

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* Do others have a right-of-way or easement over the stream crossing?

Yes

Not Sure

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* Are there utilities in the roadway?

Water

Phone/Cable

Electrical-buried

Electrical-overhead

None

Unknown

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* Any other known barriers upstream or downstream from your site?

Yes

Unknown

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* Is there a cost-share for your site?

Yes

Unknown

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* I certify that the information above is correct; and that I choose to enroll in the Family Forest Fish Passage Program and have my site evaluated for potential barrier/s.

Name:

Date:

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* Contact Information

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* Who will be the main contact for your project?

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* If the landowner is represented by someone other than themselves, please provide their information below

Question Title

* How did you find out about the program?

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* How many acres do you own?

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* Site Location

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* Legal Description

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* Forest Practices application number (if applicable)

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* Number of barriers you are applying for

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* Type and amount of barriers

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* What is the name of the stream the barrier is located on?

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* Do others have a right-of-way or easement over the stream crossing?

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* Are there utilities in the roadway?

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* Any other known barriers upstream or downstream from your site?

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* Is there a cost-share for your site?

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* I certify that the information above is correct; and that I choose to enroll in the Family Forest Fish Passage Program and have my site evaluated for potential barrier/s.

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* Please provide driving directions for reaching the site.