Required Project Blank Forms
Unless noted otherwise for specific items such as traffic counts, all policies and forms apply to both the “Dirt and Gravel” and “paved Low Volume Road” portions of the Program.
Standard Program Forms
- Traffic Count Validation (162 KB): Form for recording traffic counts to insure that paved Low Volume Roads have traffic counts of ≤500 vehicles per day in order to be eligible for funding. Includes instructions to complete the traffic count validation form.
- Stream Crossing Eligibility Determination: Visit for specific forms related to Stream Crossings.
- Driving Surface Aggregate: Visit for specific forms related to DSA.
Grant Application Packet
- Grant Application: One-page application submitted by the road-owning entity to the Conservation District. This, along with the work plan, becomes “Attachment A” to the contract between the Conservation District and the Grant recipient.
- Work Plan: Project sketch detailing proposed work. Can be on the back of the grant application.
- Expenditure Sheets: Two optional sheets, one for grant requested funds and one for in-kind contributions, that can be attached to the grant application if needed.
- Instructions: Instructions for completing the Grant Application.
- Grant Application Packet – Fillable (1.67 MB): Includes the four forms mentioned above. Note that this form is a fillable pdf and is not meant for completing by hand.
- Grant Application Packet – Not Fillable (1.60 MB): The non-fillable version of the Grant Application. Use this for completing by hand.
Scope of Work
- Project Scope of Work (1.07 MB): NEW form summarizing “proposed deliverables” to a contract. Instructions coming soon
Contract
- 2-page Contract (601 KB): Legal contract between the conservation district and the grant recipient with instructions.
- Contract Attachments:
- Attachment A: Grant application and work plan (see above)
- Attachment B (167 KB): General Contract Provisions – General legal provisions pertaining to the contract.
- Attachment C: QAB Standards (Visit a specific Conservation District page for QAB policies.)
- Attachment D: Schedule of Payments (see below)
- Attachment E (404 KB): Prevailing Wage Notification Letter
- Contract Amendment (1.24 MB): Simple amendment form that can be used to increase the funding amount or extend the completion date of an existing contract. (funding can be increased by 40% (or more with SCC approval) over original contract).Includes the required attachment for amendments that require SCC approval and instructions to complete a contract amendment.
- Schedule of Payments (707 KB): Single page form that outlines the procedure in which funding will be distributed to a successful grant applicant. This becomes “Attachment E” to the contract between the Conservation District and the Grant recipient.
Project Completion Report
- Project Completion Report (1.13 MB): Report used to summarize a completed project. Continues a summary of both financial information and the practices implemented on the project. It is recommended that conservation districts and grant recipients jointly complete this form as part of the final inspection. Instructions coming soon




