Application for Perpetual Easement Under CREP - Wisconsin
3545481571500ARM-LWR-209 (rev. 08/17)DATCP USE ONLY:323855080000Wisconsin Department of Agriculture, Trade and Consumer ProtectionDivision of Agricultural Resource ManagementPO Box 8911, Madison, WI 53708-8911(608)224-4632RECEIVED DATE: ______________PERPETUAL EASEMENT APPLICATIONWis. Stats. Sec 93.70 SECTION 1A. COUNTY INFORMATION: FORMTEXT ?????Separate applications must be made for enrolling lands in two or more counties.RESPONSIBLE COUNTY AGENCY: FORMTEXT ?????AUTHORIZED COUNTY REPRESENTATIVE: FORMTEXT ?????ADDRESS: FORMTEXT ?????CITY: FORMTEXT ?????STATE: FORMTEXT WIZIP CODE: FORMTEXT ?????TELEPHONE NUMBER: ( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????EMAIL: FORMTEXT ????? EASEMENT HOLDER Perpetual conservation easement is to be held by: (choose one) FORMCHECKBOX County FORMCHECKBOX DATCP FORMCHECKBOX Other FORMTEXT ????? SECTION 1B. LANDOWNER and FEDERAL CONTRACT INFORMATION All legal owners as indicated on the deed(s) for the land identified in Section 3 must be listed below along with contact information. Primary Landowner Type (check one) FORMCHECKBOX Individual FORMCHECKBOX Corporation FORMCHECKBOX Partnership FORMCHECKBOX Trust FORMCHECKBOX Other1.) NAME OF LANDOWNER (Primary): FORMTEXT ????? (Individual, Corporation, Partnership etc. Spouse of an individual owner must be included)ADDRESS: FORMTEXT ????? CITY: FORMTEXT ????? STATE: FORMTEXT ?? ZIP CODE: FORMTEXT ?????TELEPHONE NUMBER: ( FORMTEXT ???) FORMTEXT ???- FORMTEXT ???? EMAIL: FORMTEXT ????? PERCENT OF PAYMENT: FORMTEXT ???? 2.) NAME OF LANDOWNER: FORMTEXT ?????ADDRESS: FORMTEXT ????? CITY: FORMTEXT ????? STATE: FORMTEXT ?? ZIP CODE: FORMTEXT ?????TELEPHONE NUMBER: ( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????EMAIL: FORMTEXT ????? PERCENT OF PAYMENT: FORMTEXT ????3.) NAME OF LANDOWNER: FORMTEXT ?????ADDRESS: FORMTEXT ????? CITY: FORMTEXT ????? STATE: FORMTEXT ?? ZIP CODE: FORMTEXT ?????TELEPHONE NUMBER: ( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????EMAIL: FORMTEXT ????? PERCENT OF PAYMENT: FORMTEXT ????4.) NAME OF LANDOWNER: FORMTEXT ?????ADDRESS: FORMTEXT ????? CITY: FORMTEXT ????? STATE: FORMTEXT ?? ZIP CODE: FORMTEXT ?????TELEPHONE NUMBER: ( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????EMAIL: FORMTEXT ?????5.) NAME OF LANDOWNER: FORMTEXT ?????ADDRESS: FORMTEXT ????? CITY: FORMTEXT ????? STATE: FORMTEXT ?? ZIP CODE: FORMTEXT ?????TELEPHONE NUMBER: ( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????EMAIL: FORMTEXT ?????6.) NAME OF LANDOWNER: FORMTEXT ?????ADDRESS: FORMTEXT ????? CITY: FORMTEXT ????? STATE: FORMTEXT ?? ZIP CODE: FORMTEXT ?????TELEPHONE NUMBER: ( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????EMAIL: FORMTEXT ?????NOTE: Payments can only be made to up to three separate legal landowners and will be made in the manner indicated by the percentages listed above.SECTION 1B. LANDOWNER and FEDERAL CONTRACT INFORMATION CONTINUEDFEDERAL CONTRACT INFORMATIONCRP-1 CONTRACT NUMBER(S): FORMTEXT ?????, FORMTEXT ?????, FORMTEXT ?????FARM NUMBER: FORMTEXT ?????CREP Reenroll: FORMCHECKBOX CRP-1 EFFECTIVE DATE: FORMTEXT ?????(CRP-1, Box 9) AGREEMENTEXPIRATION DATE: FORMTEXT ?????(CRP-1, Box 9) PRIOR STATE AGREEMENT(s) #: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????(Reenrolls only)SECTION 2. NOTICE TO MORTGAGE HOLDER & LAND CONTRACT VENDOR ALL MORTGAGE HOLDERS OR LAND CONTRACT VENDORS MUST SIGN THIS APPLICATION. I hereby acknowledge receipt of notice that the parcels listed in this CREP application, as applicable, are applying for a perpetual conservation easement and understand that I will be required to sign the easement. The signature of the mortgage holder/lender or Land Contract Vendor shall not be construed as a subordination of its mortgage lien or land contract rights nor as of any other significance beyond receipt of the notice herein. 1.) FORMCHECKBOX Mortgage FORMCHECKBOX Land Contract LENDER/VENDOR NAME: FORMTEXT ?????REPRESENTIVE NAME: FORMTEXT ????? REPRESENTATIVE TITLE: FORMTEXT ????? REPRESENTIVE SIGNATURE: ________________________________________ DATE: _____________2.) FORMCHECKBOX Mortgage FORMCHECKBOX Land Contract LENDER/VENDOR NAME: FORMTEXT ?????REPRESENTIVE NAME: FORMTEXT ????? REPRESENTIVE TITLE: FORMTEXT ????? REPRESENTIVE SIGNATURE: ________________________________________ DATE: _____________3.) FORMCHECKBOX Mortgage FORMCHECKBOX Land Contract LENDER/VENDOR NAME: FORMTEXT ?????REPRESENTIVE NAME: FORMTEXT ????? REPRESENTIVE TITLE: FORMTEXT ????? REPRESENTIVE SIGNATURE: ________________________________________ DATE: _____________4.) FORMCHECKBOX Mortgage FORMCHECKBOX Land Contract LENDER/VENDOR NAME: FORMTEXT ?????REPRESENTIVE NAME: FORMTEXT ????? REPRESENTIVE TITLE: FORMTEXT ????? REPRESENTIVE SIGNATURE: ________________________________________ DATE: _____________Other Parties with Interest in the Land: (List below the type of interest, name of party and contact information if available of other known parties with legal interest in the land. Such as mineral rights, rail road corridors, pipelines, right of first refusal, etc) FORMTEXT ?????SECTION 3. LOCATION and PAYMENT ESTIMATE (Attach additional sheets as necessary)Lands indicated on the Conservation Plan must match lands listed in this section. A completed conservation plan is required prior to executing a perpetual conservation easement.Table IA. CP FORMTEXT ??? (One practice per section)FARM #: REF FarmNumberTbl1 \h TRACT#: FORMTEXT ????? CRP-1 #: REF ContractNumber1 \h CREP PRACTICE TYPE FORMCHECKBOX RIPARIAN FORMCHECKBOX GRASSLANDMUNICIPALITYACRES ? ? 1/4SECTIONTOWNSHIPRANGEPARCEL TAX IDFIELD #’s FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ?????TILLABLERate1: FORMTEXT ????? X FORMTEXT ????? ACRES X 12 = B. FORMTEXT =TillRate1 * TillAcres1 * 12 0$0.00NON-TILLABLERate1: FORMTEXT ????? X FORMTEXT ????? ACRES X 12 = C. FORMTEXT =NonTillRate1 * NonTillAcres1 * 12 0$0.00D.TOTAL ACRES (Till+Non-Till) FORMTEXT =TillAcres1 + NonTillAcres1 00.00E. INCENTIVE PAYMENT (B+C) FORMTEXT =(TillRate1 * TillAcres1 * 12)+(NonTillRate1 * NonTillAcres1 * 12) 0$0.00F. ESTIMATED (.40 x Practice cost) PRACTICE PAYMENT2 FORMTEXT ?????Table IIA. CP FORMTEXT ??? (One practice per section)TRACT#: FORMTEXT ????? CRP-1 #: REF ContractNumber2 \h CREP PRACTICE TYPE FORMCHECKBOX RIPARIAN FORMCHECKBOX GRASSLANDMUNICIPALITYACRES ? ? 1/4SECTIONTOWNSHIPRANGEPARCEL TAX IDFIELD #’s FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ?????TILLABLERate1: FORMTEXT ????? X FORMTEXT ????? ACRES X 12 = B. FORMTEXT =TillRate2 * TillAcres2 * 12 0$0.00NON-TILLABLERate1: FORMTEXT ????? X FORMTEXT ????? ACRES X 12 = C. FORMTEXT =NonTillRate2 * NonTillAcres2 * 12 0$0.00D.TOTAL ACRES (Till+Non-Till) FORMTEXT =TillAcres2 + NonTillAcres2 00.00E. INCENTIVE PAYMENT (B+C) FORMTEXT =(TillRate2 * TillAcres2 * 12)+(NonTillRate2 * NonTillAcres2 * 12) 0$0.00F. ESTIMATED (.40 x Practice cost)PRACTICE PAYMENT2 FORMTEXT ?????A. CP FORMTEXT ??? (One practice per section)TRACT #: FORMTEXT ????? CRP-1 #: REF ContractNumber3 \h CREP PRACTICE TYPE FORMCHECKBOX RIPARIAN FORMCHECKBOX GRASSLANDMUNICIPALITYACRES ? ? 1/4SECTIONTOWNSHIPRANGEPARCEL TAX IDFIELD #’s FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN FORMTEXT ?? FORMTEXT ??? FORMTEXT ??? FORMTEXT ????? FORMTEXT ?????TILLABLERate1: FORMTEXT ????? X FORMTEXT ????? ACRES X 12 = B. FORMTEXT =TillRate3 * TillAcres3 * 12 0$0.00 NON-TILLABLERate1: FORMTEXT ????? X FORMTEXT ????? ACRES X 12 = C. FORMTEXT =NonTillRate3 * NonTillAcres3 * 12 0$0.00D.TOTAL ACRES (Till+Non-Till) FORMTEXT =TillAcres3 + NonTillAcres3 00.00E. INCENTIVE PAYMENT (B+C) FORMTEXT =(TillRate3 * TillAcres3 * 12)+(NonTillRate3 * NonTillAcres3 * 12) 0$0.00F. ESTIMATED (.40 x Practice cost)PRACTICE PAYMENT2 FORMTEXT ?????TOTAL EASEMENT ACRES: FORMTEXT =((TillAcres1 + NonTillAcres1)+(TillAcres2 + NonTillAcres2)+(TillAcres3 + NonTillAcres3)) 00.00 -63500891761 based on information from the appropriate form CRP-2C, Block #15 2 based on information in federal form CRP-1, Block #11E001 based on information from the appropriate form CRP-2C, Block #15 2 based on information in federal form CRP-1, Block #11E(Add all Section 3. D’s)TOTAL ESTIMATED INCENTIVE PAYMENT: FORMTEXT =((TillRate1 * TillAcres1 * 12)+(NonTillRate1 * NonTillAcres1 * 12)) + ((TillRate2 * TillAcres2 * 12)+(NonTillRate2 * NonTillAcres2 * 12)) + ((TillRate3 * TillAcres3 * 12)+(NonTillRate3 * NonTillAcres3 * 12)) 0$0.00 (Add all Section 3. E’s)Table IIISECTION 4. SIGNATURESThis application is for a perpetual conservation easement from the Wisconsin Conservation Reserve Enhancement Program (WI CREP). The purpose of this program is to improve water quality and enhance wildlife habitat. A complete application includes the following forms and materials: FORMCHECKBOX W-9 (Signed by landowner for those requesting payment as indicated in Section 1B) FORMCHECKBOX Map (Clearly delineating the CREP area enrolled under the agreement along with other natural or man-made features such as lakes, ponds, swamps, rivers, streams, wood lots, roads, power lines, fences, lot lines, field boundaries and numbers, and structures including barns, houses and storage facilities) FORMCHECKBOX GPS Data of Monument Locations (WISCRS Coordinates) FORMCHECKBOX CRP-1 (Signed by FSA) FORMCHECKBOX CRP-2C FORMCHECKBOX CRP-23/24 (FSA approval letter to landowner) FORMCHECKBOX Property Tax Bills (for all parcel(s) indicated in Section 3) FORMCHECKBOX Title Search (for all parcel(s) indicated in Section 3. See TS Attachment for details) FORMCHECKBOX Ownership Documents (to identify ownership such as deeds) FORMCHECKBOX Signing Authority Documents (to identify signature authority for trusts, corporations, partnerships, POA, etc) FORMCHECKBOX Environmental Benefit Report Summary (LWR-284)Prior to executing a perpetual conservation easement, I must have completed a CRP-1, CRP-2C, a Conservation Plan, and a full title search of the property. The title search must go back to the first entry and disclose ownership and encumbrances on the lands submitted in this application. All parties with a legal interest in the land are required to sign the final easement document.By submitting my application I authorize the WI CREP to begin the eligibility determination process for my property. I understand that the Farm Service Agency (FSA) will determine my initial eligibility and that my signature below does not constitute an eligibility determination. I also understand that my signature below does not obligate me to participate in the program nor does it obligate the WI CREP to make payments to me until a valid agreement and easement is executed; however, should I withdraw my application at any time during the title search, I understand that I am obligated to pay for all title search costs.My signature below indicates that I have examined the application and all attached forms and materials and I certify that to the best of my knowledge and belief the application is true and correct._________________________________________________ _____________SIGNATURE OF LANDOWNER DATE FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________PRINT NAME FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________TITLE or REPRESENTATIVE CAPACITY _________________________________________________ _____________SIGNATURE OF LANDOWNER DATE FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________PRINT NAME FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________TITLE or REPRESENTATIVE CAPACITY _________________________________________________ _____________SIGNATURE OF LANDOWNER DATE FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________PRINT NAME FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________TITLE or REPRESENTATIVE CAPACITY _________________________________________________ _____________SIGNATURE OF LANDOWNER DATE FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________PRINT NAME FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________TITLE or REPRESENTATIVE CAPACITY _________________________________________________ _____________SIGNATURE OF LANDOWNER DATE FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________PRINT NAME FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________TITLE or REPRESENTATIVE CAPACITY _________________________________________________ _____________SIGNATURE OF LANDOWNER DATE FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________PRINT NAME FORMTEXT ?????____________________________________________________________________________________________________________________________________________________________________________________________________TITLE or REPRESENTATIVE CAPACITY 3432175000ARM-LWR-209 TS Attachment (rev. 05/17)TS ATTACHMENT25403083900 Wisconsin Department of Agriculture, Trade and Consumer ProtectionDivision of Agricultural Resource ManagementPO Box 8911, Madison, WI 53708-8911(608)224-4632CREP Title Search Contracting Request FormSUBMIT THIS DOCUMENT TO TITLE COMPANYDate: FORMTEXT DATE \@ "M/d/yyyy" 11/20/20176/20/2017Estimated Cost of Title Search: $ ______________Name: REF Owner1Name \h Address: REF Owner1Address \h REF Owner1City \h , REF Owner1State \h REF Owner1Zip \h I am requesting a title search of the parcel(s) indicated below: County: REF County \h \* MERGEFORMAT ? ??SecTwnRngParcel Number(s):Municipality REF qrtqrttbl1r1 \h REF qrttbl1r1 \h REF Sectbl1r1 \h REF Twptbl1r1 \h REF Rngtbl1r1 \h REF Parceltbl1r1 \h REF Munitbl1r1 \h REF qrtqrttbl1r2 \h REF qrttbl1r2 \h REF Sectbl1r2 \h REF Twptbl1r2 \h REF Rngtbl1r2 \h REF Parceltbl1r2 \h REF Munitbl1r2 \h REF qrtqrttbl1r3 \h REF qrttbl1r3 \h REF Sectbl1r3 \h REF Twptbl1r3 \h REF Rngtbl1r3 \h REF Parceltbl1r3 \h REF Munitbl1r3 \h REF qrtqrttbl1r4 \h REF qrttbl1r4 \h REF Sectbl1r4 \h REF Twptbl1r4 \h REF Rngtbl1r4 \h REF Parceltbl1r4 \h REF Munitbl1r4 \h REF qrtqrttbl2r1 \h REF qrttbl2r1 \h REF Sectbl2r1 \h REF Twptbl2r1 \h REF Rngtbl2r1 \h REF Parceltbl2r1 \h REF Munitbl2r1 \h REF qrtqrttbl2r2 \h REF qrttbl2r2 \h REF Sectbl2r2 \h REF Twptbl2r2 \h REF Rngtbl2r2 \h REF Parceltbl2r2 \h REF Munitbl2r2 \h REF qrtqrttbl2r3 \h REF qrttbl2r3 \h REF Sectbl2r3 \h REF Twptbl2r3 \h REF Rngtbl2r3 \h REF Parceltbl2r3 \h REF Munitbl2r3 \h REF qrtqrttbl2r4 \h REF qrttbl2r4 \h REF Sectbl2r4 \h REF Twptbl2r4 \h REF Rngtbl2r4 \h REF Parceltbl2r4 \h REF Munitbl2r4 \h REF qrtqrttbl3r1 \h REF qrttbl3r1 \h REF Sectbl3r1 \h REF Twptbl3r1 \h REF Rngtbl3r1 \h REF Parceltbl3r1 \h REF Munitbl3r1 \h REF qrtqrttbl3r2 \h REF qrttbl3r2 \h REF Sectbl3r2 \h REF Twptbl3r2 \h REF Rngtbl3r2 \h REF Parceltbl3r2 \h REF Munitbl3r2 \h REF qrtqrttbl3r3 \h REF qrttbl3r3 \h REF Sectbl3r3 \h REF Twptbl3r3 \h REF Rngtbl3r3 \h REF Parceltbl3r3 \h REF Munitbl3r3 \h REF qrtqrttbl3r4 \h REF qrttbl3r4 \h REF Sectbl3r4 \h REF Twptbl3r4 \h REF Rngtbl3r4 \h REF Parceltbl3r4 \h REF Munitbl3r4 \h The title search should: Be a full title search that is unrestricted as to the time back to the 1st entry. (Title search document should clearly identify that the search was back to “1st entry” or “Patent”.)Provide a title insurance policy commitment (specifically, a “Minimum Title Insurance Commitment of $15,000”) including but not limited to the following:Names of all present owners.Tax statement of property from assessors office.Last deed of record including legal description and any exceptions.All easements of record and other encumbrances such as utilities, secondary roads and dedications unrestricted as to time.All land contracts unrestricted as to time.Judgments, Liens, Mortgage information, delinquent real estate taxes, state and federal tax liens unrestricted as to time.CSMs and Subdivision Plats if applicable.Include copy of deeds, land contracts, easements of record and other encumbrances listed in the search results. FORMTEXT ????? ................
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