TreePlantingApplication

Application

Loudoun Soil and Water Conservation District and Loudoun County

Non-Agricultural Tree Planting Program

Name
Name
First Name
Last Name
Address
Address
City
State/Province
Zip/Postal
Country

APPLICANT’S REQUEST: By submitting this request for funding under the Loudoun Soil and Water Conservation District (“LSWCD”) and Loudoun County (“County”) Non-Agricultural Tree Planting Program(“Project”), I agree, if the funding is granted: (1) To install and maintain the following plant materials between March 1, 2025 and December 15, 2025, on the Subject Property and within the Planting Area shown on the sketch attached to this Application:

Choose Option 1 or 2
And to supplement the above with
(Plant material shall include a minimum of 3 different species per category (canopy and understory) selected from the approved plant list, or as otherwise approved.)

(2) To install and maintain similar supplemental plant material within the Planting Area by December 15, 2025, to achieve 75 percent survival with uniform distribution, as determined in the sole discretion of the LSWCD and/or County, at one year from the date of initial installation; (3) That the cost of installing such similar supplemental plant material (including labor) shall be at my own expense and not eligible to receive funding under the Project; (4) That plant material and supplemental plant material installed under the Project shall not be removed, nor altered, without the prior written approval of the LSWCD and/or County; (5) To allow appropriate employees of the LSWCD and County, and their authorized agents, access to the Subject Property for the purpose of evaluation, design, and inspection of said plant materials for two years from the date of initial installation; (6) That my eligibility to receive funding under the Project ($7,000 per acre maximum reimbursement for eligible plant materials and labor expenses) is determined at the sole discretion of the LSWCD and/or County, and will require the submission of all receipts for such plant material and labor. Furthermore, by requesting funding under the Project I understand that: (A) My participation in the Project does not relieve me from compliance with applicable ordinances, laws, and regulations that may exist at any level of government; (B) LSWCD and County make no representation in regard to the existence of any covenants, easements, and/or restrictions that may apply to the Subject Property; (C) Applicant shall be solely responsible for compliance with any covenants, easements, and/or restrictions that apply to the Subject Property; (D) My application to participate in the Project does not guarantee that any or all of my request will be funded; and (E) That any funding I receive under the Project may be considered income and that I am solely responsible for compliance with all applicable tax requirements including requirements of the Internal Revenue Service.

Upon submission, this application will be sent to Chris Van Vlack (chris.vanvlack@lswcd.org) and Jennifer Venable (jennifer.venable@lswcd.org) of the Loudoun Soil and Water Conservation District
30 Catoctin Circle, SE, Suite 218
Leesburg, VA 20175
571-918-4530

DO NOT FILL IN BELOW THIS LINE (THIS SECTION FOR COUNTY USE ONLY):

Impaired?
Approved for cost-share?