FLORIDA FISH AND WILDLIFE CONSERVATION COMMISSION INVASIVE PLANT MANAGEMENT SECTION INVASIVE PLANT MANAGEMENT APPLICATION This application contains the forms required to obtain a permit for the control of aquatic vegetation pursuant to the rules of Chapter 68F-20, Florida Administrative Code GENERAL INSTRUCTIONS 1. The name, signature, address and telephone number of the riparian owner and the riparian owner's agent (if applicable) must be provided on the application. 2. Persons representing multiple riparian owners such as governmental agencies and officers of homeowner associations may apply without providing name, address, telephone and signature of all affected riparian owners. 3. The applicant must provide a map with clear directions to the proposed management site using county, state, and U.S. highway names and route numbers. 4. The applicant must complete all sections of this application. 5. In addition to this application, the applicant must provide a detailed diagram of the proposed management site which shall include, at a minimum, the following: a. riparian owner's property boundaries. b. approximate location of the water's edge. c. all aquatic plant communities within the site identified by name or symbol, with clear depiction between those plants which are to be controlled and those not to be controlled. d. all permanent features such as docks, fences, trees, etc., located near the water’s edge. e. dimensions of property, dimensions of vegetation proposed for control and vegetation not to be controlled. f. legends that explain all symbols and patterns used. 6. Each applicant shall submit a complete application bearing original signatures (including maps and diagrams). 7. All documents must be of good quality, clearly legible and submitted on 8 1/2 X 11 inch paper. 8. A separate application is required for each waterbody. 9. Submission of false or inaccurate information may result in denial of the application or suspension or revocation of the permit. 10. Riparian owners may, upon request, be required to show proof of ownership. 11. Applications are to be submitted to the regional biologist’s office as shown on page 6 of this form. FWC Form 50-032(16) Page 1 of 6 FOR OFFICIAL USE ONLY Date Class ______________________ Received _____________________ To FWC _________________________ Natural ____________________ Complete _____________________ From FWC _______________________ OFW ______________________ Surveyed _____________________ Reviewer _________________________ Latitude ____________________ Permit # ______________________ WCODE _________________________ Longitude ___________________ APPLICANT INFORMATION (Please Print) Name of Riparian Owner __________________________________ Name of Agent/Applicant ___________________________________ Mailing Address __________________________________ Mailing Address ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ Telephone __________________________________ Telephone ___________________________________ Natural ______ OFW _____ Class______ FOR OFFICIAL USE ONLY Date _____________________________Date________________ _____________________________Date________________ Received__________ Signature of Riparian Owner To GFC __________ Signature of Agent/Applicant Complete__________ From GFC__________ Surveyed__________ Reviewer__________ Permit #__________ WCODE __________ CHECK THE APPROPRIATE BOX Natural ______ OFW _____ Class______ New Permit Modification to Application Existing Permit Existing Permit Number ______________________________ WATERBODY INFORMATION Name of Waterbody______________________________________________________________________________________ County of Waterbody_____________________________________________________________________________________ Acreage of Waterbody____________________________________________________________________________________ Type of Waterbody (Check all that apply) Aquatic plants are restricting (Check all that apply) FWC Form 50-032(16) Lake River Canal Other_________________________ Public Private More than one owner Fishing Swimming Boating Access Aesthetics Wildlife Observation Other______________________________________ Page 2 of 6 TYPE OF CONTROL METHOD REQUESTED (CHECK ALL THAT APPLY) _____Herbicide _____Hand Removal _________________________________________________________________________________ (list plant disposal methods) _____Mechanical _________________________________________________________________________________ (list equipment to be used and disposal methods) _____Water Level Fluctuation _________________________________________________________________________________ (list proposed beginning and ending dates) _____Other _________________________________________________________________________________ (explain) Name of target plant Example: FWC Form 50-032(16) Cattail Control area (sq.ft./acres) Control method Herbicide to be used 50'x 25'= 0.03ac Hand remove not applicable Page 3 of 6 TYPE OF PUBLIC NOTIFICATION TO BE USED: (Check all that apply) [MUST provide notification to the public when using a herbicide that requires water use restrictions] _______ Signs posted at access points _______ Public notice in newspaper _______ Place notice at management site _______ Signal or marker system _______ Notice at established point of contact Other ________________________________________________ BRIEFLY EXPLAIN THE PURPOSE AND BENEFITS THAT YOUR MANAGEMENT PLAN WILL PROVIDE TO THE WATERBODY. ALSO PROVIDE ANY FURTHER INFORMATION YOU WOULD LIKE FWC TO CONSIDER IN EVALUATING YOUR PERMIT APPLICATION (ATTACH ADDITIONAL PAGES IF NECESSARY) PROVIDE DETAILED DIRECTIONS TO THE MANAGEMENT SITE, INCLUDING PHYSICAL ADDRESS (ATTACH MAP) FWC Form 50-032(16) Page 4 of 6 Site Map Please draw a detailed diagram of the proposed management site as detailed on page one of application under General Instructions, number five. FWC Form 50-032(16) Page 5 of 6 FWC Form 50-032(16) Page 6 of 6 MAIL APPLICATION TO THIS ADDRESS Field Offices Northwest Florida Field Office 3900 Commonwealth Blvd., MS705 Tallahassee, FL 32399 850-617-9430 Counties: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Leon, Liberty, Okaloosa, Santa Rosa, Wakulla, Walton, Washington, and Jefferson. Suwannee River Field Office 3377 East US Highway 90 Lake City, FL 32055 386-758-0525 Counties: Madison, Taylor, Lafayette, Suwannee, Hamilton, Columbia, Gilchrest, Dixie, Alachua, Union, Baker, Bradford, Putnam, Clay, Duval and Nassau. Southwest Florida Office 8275 East Fort Cooper Rd. Inverness, FL 34450 352-726-8622 Counties: Citrus, Hernando, Hillsborough, Levy, Marion, Pasco and Sumter. North Central Field Office 601 W. Woodard Ave. Eustis, FL 32726 321-228-3364 Counties: Lake St. Johns River Office 6830 Shadowridge Dr., Suite 201 Orlando, FL 32812 407-858-6170 Counties: Brevard, Flagler, Orange, Osceola, Seminole, St. Johns, and Volusia. South Central Florida Office 2001 Homeland-Garfield Road Bartow, FL 33830 863-534-7074 Counties: Highlands, Pinellas, Polk, Manatee, Sarasota, Charlotte, De Soto, and Hardee. South Florida Office 18150 SW Martin Hwy. Indiantown, FL 34956 772-597-5462 Counties: Glades, Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie. Everglades Field Office 298 Sabal Palm Rd. Naples, FL 34114 239-229-5403 Counties: Lee, Collier, Hendry, Broward, Miami-Dade, and Monroe.