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!
Contact 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 Crossing or Restoration
Bridge
Culvert
Water Diversions
Pond
Forest Health/Management
Habitat Enhancement
Erosion Control
Other
Brief Project Description
*
Estimated Total Project Cost
*
Estimates or Proposals from Subcontractors
*
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Project Timeline
*
Has the project started?
*
Yes
No
Documentation Uploads
Please upload any documents related to your project. This may include maps, photos, permits, correspondence, or other relevant materials. Our review team will prioritize applications that include complete supporting documentation. If you need help with uploading files, contact us at admin@ruralresilienceproject.com.
Biological Resources Assessment
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Lake and Streambed Alteration Agreement (LSAA)
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Forest Management Plan
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Engineering/Technical Design Plans
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Other Supporting Documents
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Is this project required by a regulatory agency?
*
Yes
No
If yes, please state the agency name.
Lake and Streambed Alteration Agreement (LSAA)
An LSAA is a permit issued by the California Department of Fish and Wildlife (CDFW) that authorizes work in or near rivers, streams, or lakes that may substantially alter the natural flow, bed, or bank. If your project involves culverts, grading, water diversions, or other work near water features, an LSAA may be required.If you need copies of your LSAA documentation and you are located in Region 1, please contact CDFW at R1LSAEureka@wildlife.ca.gov.
Is your project related to a Lake and Streambed Alteration Agreement (LSAA)?
Yes
No
Unsure
Which of the following was provided by CDFW in response to your Notification to CDFW:
*
LSAA signed by CDFW (Final Agreement)
Operation by Law (Op-Law) Letter signed by CDFW
No Notification Required from CDFW
Unsigned Draft Agreement, "Incomplete" Notification response letter, or Other CDFW Response Letter
Unsure
LSAA Permittee Name
*
First Name
Last Name
What is the EPIMS or 1600 Agreement Number on your Lake and Streambed Alteration document?
*
Please upload a copy of CDFW's response to your Notification (Final Agreement, Draft Agreement, Op-Law, Incomplete notification response letter, or No Notification Required, or most recent communication to/from CDFW)
*
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What is the Final Agreement or Op-Law Letter expiration date?
*
When does the Final Agreement or Op-Law expire?
*
Within the next 6 months
Within the next 12 months
Within the next 24 months
Within the next 36 months
CDFW cannot extend or amend an Op-Law letter. If you have a Final Agreement, have you submitted:
*
“Request to Extend” to CDFW
“Request to Amend” to CDFW
Were you provided an Extension letter signed by CDFW on letterhead?
*
Yes
No
Unsure
What project types are included in the LSAA?
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Stream Crossing
Water Diversion
Pond (Maintain or Remove)
Sediment Delivery
Other
Are ALL of the projects included in your Final Agreement (and Amendment(s) or Op-Law letter COMPLETED?
*
All projects have been completed.
Some or all projects are incomplete.
If you had to do "work" on a project per an LSAA, and the work is complete, did you submit a Project Inspection Report and receive a "Work Completed Letter" or other similar type letter from DFW. Did this letter get uploaded to the DCC portal and provided to the MCD?
*
Yes
No
Select all of the LSAA projects that have been COMPLETED.
*
Stream Crossing
Water Diversion
Pond (Maintain or Remove)
Sediment Delivery
Other
Select all of the LSAA projects that are NOT COMPLETED.
*
Stream Crossing
Water Diversion
Pond (Maintain or Remove)
Sediment Delivery
Other
What is the status of your the LSAA compliance plans?
*
All plans are incomplete.
Some plans are complete.
All plans are complete.
Please let us know any additional comments about your LSAA.
*
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
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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