Application for Water Resources-NonPoint Source Pollution Cost/Share Program Sign-Up
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Social Security/FEIN Number
Please enter your Social Secutity or your FEIN number
Enter a phone number where you can be reached. Including area code.
Please enter the full name of the registered landowner.
- - Choose One - -
Your email address is required for confirmation purposes.
Please answer yes or no to multiple landowner.
This form is being submitted for
Select the program you are applying for.
Land Identification: Legal Description/Tract Number
With my signature below and submission of this form, I understand that this is an application for cost share funds and that as a condition of receiving these funds I have not and will not begin construction or installation of this practice prior to contract approval by the State Conservation Commission and notification of this approval by the Wyandotte County Conservation District. Any activity related to the completion of this project prior to this notification will cancel this application and the availability of these funds. I also understand that the expiration date of June 30th on the contract is a firm date and failure to complete the project by that date will cancel the contract.
Signature of Landowner
Your signature aknowledges that you have read and agree to the above paragraph.
Please select today's date.
Enter security code exactly as shown.