Required fields are marked with asterisks (*)

Land Preservation Application

Please fill out this application below. For questions, contact Land Stewardship Coordinator Emma Campbell at 517.853.4614.

Property Owner Information:

1. Full Name

2. Address. Make sure to include street number and name, unit/apartment number, city, state, and zip code.

3. Please provide the best phone number to reach you at.

Location Information of Property to be Considered:

4. Address. Make sure to include street number and name, unit/apartment number, city, state, and zip code.

5. General Location of Land

6. Legal Description of Land (File attachment option available below if that is preferred. If attaching a document, please write N/A for this question)

6a. Legal Description Attachment (if needed)

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

7. Size of Property (in acres)

Property Information

8. Are you aware of any threatened or endangered species, or any natural features such as woodland, wetland, pond, stream, river, or open space that is existing on the proposed property?

Yes

8a. If you answered yes, please identify the natural feature and briefly describe them. If you answered no, please write N/A.

9. Are you aware if the proposed property is contiguous or adjacent to park property, school property, or land protected under the Land Preservation Program?

Yes

9a. If you answered yes, please define the contiguous or adjacent property. If you answered no, please write N/A.

10. Are you aware if the proposed property has any easements, restrictions, or special assessments?

Yes

10a. If you answered yes, please list them out. If you answered no, please write N/A.

11. Are you aware of any environmental problems on the proposed property, or have there been any in the past?

Yes

11a. If you answered yes, please identify and describe the extent of the problem and if an environmental site assessment has ever been prepared. If you answered no, please write N/A.

12. Have you considered how the proposed property will be transferred to the Land Preservation Program, such as by sale, conservation easement, combination of sale and contribution, or contribution?

Yes

12a. If you answered yes, please identify the type of transfer. If you answered no, please write N/A.

Permission Statement:

I (we) hereby grant permission for members of the Charter Township of Meridian Land Preservation Advisory Board, Township staff members, and the Township's representatives or experts the right to enter onto the above property (or as described in the attached information) in my (our) absence for the purposes of gathering information, including not limited to the taking and the use of photographs.

13. Please type your name in the box below as a digital signature.

14. Please provide the date of your submission.