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APPLICATION FOR FUNDING TRAILS, OPEN SPACE AND PARKS (TOPS) PROGRAM

Applicant:

Name: _________________________________________________________________________

Agency: ________________________________________________________________________

Address: ________________________________________________________________________

City: ______________________________________________State: ______ZIP: ______________

Telephone: (_____) __________-___________________

TYPE OF PROJECT: (Check all that apply)

Trail: ______________ Acquisition _____________ Development __________

Park: ______________ Acquisition _____________ Development __________

Open Space: ________ Acquisition _____________

OWNER: Is owner aware of this proposal? ____________

Name: _________________________________________________________________________

Agency: ________________________________________________________________________

Address: ________________________________________________________________________

City: ______________________________________________State: ______ZIP: ______________

Telephone: (_____) __________-___________________

LOCATION AND DESCRIPTION OF PROPOSED ACQUISITION:

Address: _______________________________________________________________________________ ______________________________________________________________________________________

Description ____________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Purpose of Acquisition: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Proposed Type of Acquisition:

Fee Simple _____________ Sale ____________ Trade _____________

Conservation Easement _________________ Donation _________________

Transfer of Development Rights __________ Lease ___________________ Other ____________________________________________________________________________

APPLICATION FOR FUNDING TRAILS, OPEN SPACE AND PARKS (TOPS) PROGRAM

Page Two

Proposed type of Development _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________

Please explain why this proposal is appropriate for TOPS Funding: (250 words or less) _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________

 

FOR OFFICE USE ONLY

O.S. File No. __________________________

Date of Proposal _______________________

Name of Project____________________________________________________________________________________

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