APPLICATION FOR EMERGENCY SEEDING GRANT FUNDS Access and Habitat Program Oregon Department of Fish and Wildli 4034 Fairview Industrial Drive SE Salem, OR 97302 I/We, Jon Muir. Lake District Wildli Biologist, ODFW of Lakeview, Oregon, hereby make application r financial assistance under the terms d conditions of the Access and Habitat Program in the amount of$ 5000.00______ _ I/We understand that if this project is approved r nding by the Director of the Oregon Department of Fish and Wildli (rather th by the Commission), we will be required to: • Sign a Grant Agreement containing the terms and conditions upon which nds will be released including submission of necessary permits; • Obtain landowner and maintence agreements if needed; • Sign a certification to comply with state, deral and local regulations; • Submit a completion report to the Bod on project perrmance. Signature: d' Date: �)o i z � �, Position: �,J,,6 hS ,t1/ 01� Note: Filing of s plication does not gutee ceptce of the proposal nor y poion thereof. Applicts whose projects e approved by e Director of the Oregon Deptment of Fish d Wildlife will be notified by telephone and mail. 1

APPLICATION FOR EMERGENCY SEEDING … fire...APPLICATION FOR EMERGENCY SEEDING GRANT FUNDS Access and Habitat Program Oregon Department of Fish and Wildlife 4034 Fairview Industrial

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APPLICATION FOR EMERGENCY SEEDING GRANT FUNDS

Access and Habitat Program

Oregon Department of Fish and Wildlife

4034 Fairview Industrial Drive SE

Salem, OR 97302

I/We, Jon Muir. Lake District Wildlife Biologist, ODFW of Lakeview, Oregon, hereby make application for financial assistance under the terms and conditions of the Access and Habitat Program in the amount of$ 5000.00 ______ _

I/We understand that if this project is approved for funding by the Director of the Oregon Department of Fish and Wildlife (rather than by the Commission), we will be required to:

• Sign a Grant Agreement containing the terms and conditions upon whichfunds will be released including submission of necessary permits;

• Obtain landowner and maintenance agreements if needed;

• Sign a certification to comply with state, federal and local regulations;

• Submit a completion report to the Board on project performance.

Signature: d;/--' Date: �)oiz�

�,

Position: �,",+v,J,,..,6 hSM- ,;... /A.,},L1Jt1/.E- $10/ot,,1�,r-

Note: Filing of this application does not guarantee acceptance of the proposal nor any portion thereof. Applicants whose projects are approved by the Director of the Oregon Department of Fish and Wildlife will be notified by telephone and mail.