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Legislative-Citizen Commission on Minnesota Resources
ENRTF 2013 Land Acquisition Submission Form

Environment and Natural Resources Trust fund logo


   Environment and Natural Resources Trust Fund
   2013 Land Acquisition Initial Reporting Form


   As required by M.S. 116P.16 for interest in land acquired with Environment and Natural Resource Trust Fund
   proceeds after June 30, 2005.

* Denotes a required field.

Note: If you have difficulty using this online submission form,  please contact LCCMR staff.

* Original Purchaser (entity/organization/agency):
* Name of Person Submitting Report:
* Address:
* City: * State: * Zip Code:
* Phone:
* Email:
Legal Citation
* Legal citation of TF appropriation (e.g. M.L. 2005, 1st Special Session, Art.1, Sec. 2, Subd. XX):

In addition, for Habitat Corridors indicate work program section -- easements (3a, 3b, 3c, etc) and/or acquisition (4a, 4b, 4c, etc) and for Metro Corridors acquisitions indicate work program section (3.1, 3.2, 3.3, etc).
Acquisition Details
* Purchase Date (mm/dd/yyyy):
*Working Title(s) of this Acquisition:
(if more than one title is used by partners, provide the other working titles. e.g. Miles property, Vermillion view property.)
* Type of Purchase (check appropriate box):   Fee Conservation Easement None
Location: * County:

City:

Township:
 Range:

Section:

¼ Section:

¼ ¼ Section:


Please specify a file:

If more than one file, provide a single zip file.
* Size in acres (provide total acres to the nearest one tenth acre): 
  Natural Resource Conservation Values in Acres  (e.g. wetland/upland, prairie/grassland, forested, other) :
  Describe Adjacency to Public/Private Conservation Lands:
  Name of Adjacent Body of Water  (if applicable):
 		  Amount of Shoreline (linear feet/miles):
Funding
  Purchase Price: $   Appraised Value: $
Related Professional Service Costs: $ Total Project Costs: $
Source of Money
Amount of Funds ($)
% of Total Project Costs
Proportional Size (acres)
Environment & Natural Resources Trust Fund
Other State Money
Federal Money
Regional/Local Government Money
Non-profit Money
Bargain Sale/Donation Value
Other Money
Total Funds
Parcel Status
Who owns interest in parcel? Check the appropriate option.
a. Interest is retained by original purchaser
b. Interest in the property was simultaneously transfered to another entity as part of the original purchase arrangements.
c. Interest in the property was transferred to another entity on (mm/dd/yyyy)
Check appropriate option(s) for who owns and manages the property as of the date of this report.
Fill in contact information below.
           DNR, Wildlife Management Area - Name of WMA
           DNR, Scientific and Natural Area - Name of SNA
           DNR, Aquatic Management Area - Name of AMA
           DNR, State Park - Name of State Park
           DNR, Forestry - Name of Forestry Unit
           DNR, Trails & Waterways - Name of trail or access
           U.S. Fish and Wildlife Service
           Local Unit of Government, specify what county or city and unit name
           Other, specify what county or city and unit name
                                            Primary Contact #1

                                            * Name:
                                            * Address:
                                            * City: * State: * Zipcode:
                                            * Phone:
                                            * Email:

                                            Primary Contact #2

                                            Name:
                                            Address:
                                            City: State: Zipcode:
                                            Phone:
                                            Email:
Other Information
Notes/Comments: