Forestry Riparian Easement Program Application

Please complete one (1) application for each forestry riparian easement eligible Forest Practices Application (FPA) after the harvest has been completed or when the harvest FPA has been disapproved by rule.

Question Title

* Contact Information

Landowner/s:

Mailing address:

City:

State:

Zip Code:

Home phone:

Cell phone:

Email address:

Question Title

* Property Information

County property is located in:

Parcel number/s:

Question Title

* Forest Practices Application number/s associated with this application:

Question Title

* Harvest Information

	Yes	No
Harvest has been completed	Harvest has been completed Yes	Harvest has been completed No
Cannot be harvested due to Forest Practice Rule restrictions	Cannot be harvested due to Forest Practice Rule restrictions Yes	Cannot be harvested due to Forest Practice Rule restrictions No

Question Title

* I certify that all of the following applies: I am willing to sell or donate an easement to the State. I am a “qualifying small forest landowner” as defined by RCW 76.13.120(2)(b) and the information I have provided is true to the best of my knowledge. I understand that my participation in Washington State’s Forestry Riparian Easement Program is conditioned upon the accuracy of my representations contained in this document and upon my compliance with all rules governing Washington State forest practices and forestry riparian easements.

Yes