For MWA Use Only

For MWA Use Only MWA PROJECT APPLICATION FORM MWA Project #: Minnesota Waterfowl Association Date Received: 907 First Street North Hopkins, MN 55343 952/767-0320 phone 952/767-0324 fax Approved: Yes No

Rev. 12/08 Date:

APPLICANT INFORMATION Name: Address: City: State: Zip: Phone (home): Phone (work): Is Applicant Landowner? YES NO

APPLICATION INFORMATION (Please check all that apply) Acquisition* Habitat Projects* Other Projects* Fee-Title Wetland Restoration Nesting Structures – Easement - Perpetual Wetland Enhancement Wood Duck Box Easement -Limited Wetland Creation excavation Nesting Structure - Other Other Wetland Creation impoundment Natural Resources Nesting Cover -Grass seeding Study/Inventory Vegetation Management – Education Wild Rice or Other MWA Project Sign Predator Management Equipment Other Other:

* Please include with application: Location map and an aerial photo identifying project site, structure location(s), property/easement lines, etc. Aerial photos are available from county USDA office or DNR

PROJECT INFORMATION/LOCATION (complete only applicable portions) Project Name:

County: Township Name: Township #: Range: Section: Project/Tract Size (acres):

MWA Funds Requested: Est. Total Cost: Est. Completion Date:

PROJECT PROPOSAL/NARRATIVE (Include Description of: Project/Proposal, Use of MWA’s Funds, Other Project Partners & Contributions, Ownership Status, etc., attach additional sheet(s) as necessary)

For MWA Use Only MWA PROJECT APPLICATION FORM MWA Project #: Minnesota Waterfowl Association Date Received: 907 First Street North Hopkins, MN 55343 952/767-0320 phone 952/767-0324 fax

GENERAL INFORMATION Project Name: Reviewer’s Name: Title/Employer: Do You Recommend MWA Funding? Reviewer’s Signature: Date:

YES NO

P ROJECT R EVIEW (Attach additional sheet(s) as necessary)

PROJECT EVALUATION: (Please discuss: Project ownership/protection, public access, visibility, project acres - upland vs. wetland, project benefits, etc.):

BIOLOGICAL EVALUATION: (Please discuss: Waterfowl producing factors of the project (i.e. shape, depth, vegetation, available nesting cover, etc.) and the project’s proximity to other public/private waterfowl producing facilities or natural resource areas.):

TECHNICAL EVALUATION: (Please discuss: Structural/technical requirements of the project, management potential/concerns, construction status, cost/acquisition concerns, legal/environmental issues, etc.):

OTHER COMMENTS: MWA PROJECT APPLICATION FORM For MWA Use Only Minnesota Waterfowl Association MWA Project #: 907 First Street North Hopkins, MN 55343 Date Received: 952/767-0320 phone 952/767-0324 fax

GENERAL INFORMATION Project Name:

MWA Chapter Name:

CHAPTER MEMBERS REVIEWING PROJECT:

COMMENTS:

FUNDING RECOMMENDATION * Chapter Funding Chapter Commitment Are Additional MWA Funds Commitment $: Includes: Needed?

Project Signs YES NO

* A chapter commitment for the above designated project will be paid from the chapter’s designated Project account and will be subject to approval by the MWA Executive Committee. Chapters are encouraged to provide an article and photos (black & white) of the project upon completion.

______Chapter Officer Date