Kansas Alliance for Wetlands and Streams
Application/Contract for Financial Assistance

Part I - Application

1. Landowner Information:

 Soc. Sec./FEIN no.                            Telephone Number



 Mailing Address

 City                                              State                Zip Code


Multiple Landowner? Yes    No     

  2.  Short Description of Project:

3.  Land Identification:

a.  Legal Description to Section:
b.  Hydrologic Unit Code (HUC 12):


Part II Computation of KAWS Fund Request:
 a. Project Components/Units Required/Unit


Total Cost


Other Funds Non Federal




* Must represent no more than 70 percent of the total project cost.
  Part III - Kansas Alliance for Wetlands and Streams Contract Approval

4. This contract made this day by and between the Kansas Alliance for Wetlands and Streams and the landowner(s) listed in section 1. above. This contract will expire on the date listed below, unless extended by KAWS or the conservation district. KAWS herby approves cost share assistance for the practices(s) listed in section 3. above in the amount of
 KAWS Amount

Submitted by Name                                              Date                                                    Expiration  Date
 Submitted By Email
I the undersigned do hereby request cost-share assistance for the installation or construction of the project measure described above.  It is understood that the total local contribution must represent at least 30 percent of total project cost received, excluding other state or federal contributions. The landowner(s)/legal agent agrees this is only an application for KAWS grant funds and does not obligate the Kansas Alliance for Wetlands and Streams (KAWS) until the application has been approved by a KAWS representative.  The landowner(s)/legal agent further  agrees, as soon as practicable after notification from the KAWS Chapter Coordinator of official KAWS approval of this application, to contract for construction and provide certification of completion (i.e. invoices and/or receipts) to the KAWS Chapter Coordinator.  By initialing below, the landowner(s) legal agent agrees to these provisions in addition to those contained in Part IV of the KAWS application form, and they are hereby incorporated into and made a part of this KAWS contract.

Landowner(s) Legal Agent (initial):   _______   _______   _______   _______              

See Part IV For Contract Between Landowner and Kansas Alliance for Wetlands and Streams