Crooked River Weed Management Area 498 SE Lynn Blvd. Prineville, OR 97754 Hitch Hikin’ Spike Phone: (541) 447-9971 Fax: (541) 416-2115 [email protected] Oregon State Noxious Weed Mascot 2015 Cost-Share Program The Crooked River Weed Management Area provides cost-share assistance to private landowners to help control noxious weeds in the Crooked River Watershed. The CRWMA will fund the cost of the herbicide or biocontrol agent; the landowner is responsible for the costs associated with application. 1. Landowner completes application and return to CRWMA by May 5, 2015. 2. CRWMA board will review applications by May 15, 2015. Approval of the application is required prior to herbicide treatment and/or release of bio control agents. Applicants will be notified of results. No receipts dated before approval will be accepted. NOTE: Some areas or situations may require a site visit. 3. CRWMA will work with approved applicants to acquire appropriate product, establish before and after photo monitoring, and GPS points/mapping requirements. 4. Landowner is responsible for the proper application of herbicide. Carefully read and follow the herbicide label. Remember to use correct spraying practices to ensure safety to you and the environment. If using biological control agents release in the manner prescribed by the supplier. 5. Landowner agrees to give CRWMA access to survey and monitor treatment sites. 6. Satellite occurrence means small isolated infestations. Those larger infestation sites will be given least priority. 7. A list of Commercial Applicators is available for interested landowners. 2015 Cost-Share Program funded Noxious Weeds African Rue Dalmatian toadflax Houndstongue Jointed goatgrass Leafy spurge (satellite occurrence) Musk thistle Mediterranean sage Scotch thistle Perennial pepperweed Yellow flag iris Diffused knapweed Medusahead (satellite occurrence) Yellow starthistle Russian knapweed (satellite occurrence) Whitetop (satellite occurrence) Spotted knapweed Possible assistance for other County A listed weed Name_____________________________________________________________________________ Address___________________________________________________________________________ Telephone & Email__________________________________________________________________ Legal Description of area for application: (Township, Range, Section, Etc)_______________________ __________________________________________________________________________________ Target Weeds:______________________________________________________________________ Approximate Size of Area to be treated per weed species:___________________________________ _________________________________________________ ________________________________ __________________________________________________________________________________ Previous CRWMA Assistance: ___________________________________Year:__________________ Expected Date of Herbicide Application: _________________________________________________ Herbicide:_________________________________________________________________________ Description of area to be treated, include the use of the land such as pasture, subdivision, lot, hayfield, lawn, subdivision parks, native grassland, etc. Please be specific on the location and provide a map and picture of the area. Also, include all other agency supports in the area that will also be supplying any assistance. (Attach map and picture or any other information for consideration to form) RELEASE and INDEMNITY The undersigned (applicant) acknowledges that they have a legal and moral duty as the owner or occupier of land to control noxious weeds. They also recognize that control measures sometimes involve risks to desirable plants, animals, and humans. In consideration of the benefit obtained by reducing the burden of their responsibility to control noxious weeds and in the recognition of risks which may be encountered, the undersigned hereby releases, holds harmless and indemnifies and defends Cooked River Weed Management Area, its agents and employees, from all loss, claims, costs and expenses, damages, lawsuits or judgments resulting from damage or destruction of property, personal injury or death of any person or persons which arise from applicants conducting weed control activity in area described in the Cost-Share Program Application including but not limited to costs of suit and reasonable attorney fees. ___________________________________ Applicant _______________________________________ CRWMA