Project Assessment Intake Form
Thank you for your interest in exploring funding opportunities for your project. This form is designed to help us understand your project’s goals, scope, and eligibility for various grant programs. By providing detailed information, you allow us to assess potential funding sources and determine how we can best assist you. For Mendocino Cultivators, please use the form found in the Technical Assistance Program page.We look forward to learning more about your project and working with you to access the resources you need to bring your vision to life!
Basic Information
Name
First Name
Last Name
Organization Name (if applicable)
Phone Number
Please enter a valid phone number.
Email
example@example.com
Mailing Address
Project Information
Project Title
Project Location (Address or Coordinates)
Assessor's Parcel Number (APN)
Property Diagram/Site Map Upload
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(File upload field for site maps)
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Type of Project:
Stream Restoration or Crossing
Bridges
Culverts
Water Diversions
Ponds
Forest Health/Management
Habitat Enhancement
Erosion Control
Other
Brief Project Description
Estimated Total Project Cost
Requested Grant Amount
Project Timeline
Has the project started?
Yes
No
Documentation Uploads
Biological Resources Assessment
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Lake and Streambed Alteration Agreement (LSAA)
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Forest Management Plan
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Estimates or Proposals from Subcontractors
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Engineering/Technical Design Plans
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Other Supporting Documents
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If yes, License Numbers, Expiration Date and Status
Has the project been reviewed or approved by regulatory agencies?
Yes
No
If yes, please list agencies and statuses
Funding Details
Have you secured other funding sources?
Yes
No
If yes, provide details
What grant program(s) are you seeking assistance with?
CDFW Cleanup, Remediation, and Watershed Enhancement Funding Opportunity
CDFW Qualified Cultivator Funding Opportunity
CAL FIRE California Forest Improvement Program
CAL FIRE Forest Health
Other (please specify)
Other (please specify)
Additional Information
Are there other stakeholders involved in the project?
Do you anticipate any challenges or barriers to project completion?
How did you hear about us?
Please Select
State Agency Referral
Website Referral
Event
Other
If referred by a State Agency, please provide their contact information
Consent Statement
Required for submission
*
“I consent to the collection and use of my information for the purposes of evaluating grant eligibility and project funding opportunities.”
“I confirm that the information provided is accurate to the best of my knowledge.”
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