Request for Assistance Assisting the Resource Conservation District (RCD) of Santa Cruz County 820 Bay Avenue, Suite 128, Capitola, CA 95010 (831)475-1967(ph); 475-3215(fax) Name: ____________________ Date of Request: Mailing Address: ____________________ Property Address: _______________________________________Acres:____________ Directions to Property and/or Nearest Cross Street: ________________________________________________________________________ Day Time Phone Number: ( ) Cell Number: (___) _____ E-Mail: __________________ Previous Landowner Name (if applicable):____________ Previous NRCS/RCD Services Provided: Yes____ NO ____ If Yes, date/yr:__________ Nature of Request: ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ I/We acknowledge that I/We am/are the landowner(s) or legal agent(s) of the subject property described above and grant permission for NRCS/RCD of Santa Cruz County to conduct an on-site inventory and evaluation and/or to provide information, advice, and/or recommendations (written or otherwise) regarding natural resource related issues or concerns that exist, or that are identified, on the property. Signature of Landowner or Official Agent ____________ ___________ Printed Name Date See Page 2 for important details regarding NRCS services _______________________________________________________________________ FOR AGENCY USE ONLY Contact Method: Mail___ E-mail ___ Phone ___ In Person ___ Referred By:_________ Ethnicity (employee declared): White_____ Black____ Asian/Pacific Islander_____ Native American/Eskimo____ Hispanic____ Watershed: _________________ Property w/in RCD Santa Cruz County? Yes___ No___ Information/Advice Provided: Information Provided By: __________________________ Date Provided: ___________ IMPORTANT NOTES REGARDING NRCS/RCD SERVICES The Natural Resources Conservation Service (NRCS) is one of the oldest government agencies of its kind. It is an agency that was essentially initiated by landowners during the “Dust Bowl” era of the 1930s. NRCS helps private landowners and land users throughout the United States and Pacific Trust territories to voluntarily conserve soil, water, air, plant, animal, wildlife and related resources. The NRCS provides conservation technical assistance, administers conservation programs and is a non-regulatory federal agency under the U.S. Department of Agriculture (USDA). All NRCS services are made available to land users, without service fees. In Santa Cruz County, NRCS works closely with, and is co-located with the Resource Conservation District (RCD) of Santa Cruz County. The RCD is a local special district organized under California state law and is supported by property tax revenue and other funding mechanisms. The NRCS is an equal opportunity provider and employer. The NRCS/RCD does not enforce laws or ordinances, issue permits, or respond to complaints in a regulatory manner. Individuals who receive advice and council from NRCS/RCD are responsible for compliance with all laws, ordinances and permit requirements. Permit coordination assistance is available on some projects through the NRCS/RCD office. The NRCS protects the confidentiality of its clients, customers and of the public according to agency policy and by the protections stipulated by the Freedom of Information Act. The NRCS and RCD of Santa Cruz County make no representation on the existence or non-existence of any utilities. It is the property owner’s or land user's responsibility to contact the Underground Service Alert Office (USA) at 1-800-642-2444 for information regarding location of underground utilities when conducting any activity that involves soil disturbances and excavations. Information provided on practices that are structural in nature is advisory and should not be considered as complete construction specifications. The property owner/land user is responsible for any further technical assistance that might be necessary. For assistance with the conservation of natural resources, you can contact the Capitola NRCS/RCD Local Partnership Office at: 831-475-1967 (NRCS); 464-2950 (RCD); or visit us on line at: www.ca.nrcs.usda.gov The web site for the RCD of Santa Cruz County is: www.rcdsantacruz.org “Helping People Help the Land” NRCS Mission Statement “To Help People Protect, Conserve and Restore Natural Resources through Information, Education and Technical Assistance Programs” RCD of Santa Cruz County Mission Statement