THE RIDGES SANCTUARY

PO BOX 152 8270 HWY 57 BAILEYS HARBOR, WI 54202 PHONE: (920) 839-2802 FAX: (920) 839-2234 marne@ridgessanctuary.org

Great Lakes Restoration Initiative - Department of Natural Resources

PHRAGMITES CONTROL PROGRAM
Section A - Application Form (TO BE COMPLETED BY LANDOWNER)
Landowner __________________________________________________________________ Address ____________________________________________________________________ City/State/Zip ________________________________________________________________ Phone Number ______________________________________________________________ Address / PIN of Phragmites ___________________________________________________________________ Parcel # (located on your property tax bill)_________________________________________________________ *By signing below I authorize the inventory and treatment of my property for the purpose of Phragmites control effort starting from the date of my signature until October 2013. Since there is no cost to the landowner and treatment will be performed below the ordinary high water mark, land owners who choose to decline this effort must do so in writing to The Ridges Sanctuary.

I, ______________________________ on this_______ day of _________________, 2011 understand that this is primarily a Phragmites control program and that educational follow up may be provided through DNR, partner organization, or contractor to help you maintain or control future infestations. I also understand that I am encouraged to be present (if possible) at the time of treatment. **If this form is not received by The Ridges Sanctuary by August 22, 2011, your property will not be included in the spray program for 2011. Section B - Site Evaluation (TO BE COMPLETED BY DCIST) 1) Width of Lot (in feet):__________________ 2) Density of Phragmites: Dense_____ Scattered_____ Sparse_____ 3) Approximate total square feet of Phragmites _____ feet x_____ feet

TRS: WDNR: GLRI:

The Ridges Sanctuary http://ridgessanctuary.org Wisconsin Department of Natural Resources http://dnr.wi.gov/org/water/greatlakes/index.htm Great Lakes Restoration Initiative http://greatlakesrestoration.us

"Preservation, education and research since 1937"