Form Lpc-1 - Application For A Land Preservation Credit Page 2
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1
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3Form LPC-1
*VALPC1213888*
Application for a Land Preservation Credit
Page 2
Section IV - Conservation Information for Reporting Purposes
A) Conservation Purpose: Identify the conservation purpose(s) protected by the donation by checking the applicable box(es). Also, specify the acreage
of each use indicated. See Instructions for definitions of these conservation purpose categories.
Conservation Purpose
Check Applicable Boxes
Acres
1. Agricultural Use
2. Forestal Use
3. Natural Habitat and Biological Diversity
4. Historic Preservation
5. Natural Resource Based Outdoor Recreation and Education
6. Watershed Preservation
7. Preservation of Scenic Open Space
8. Conservation and Open Space Lands Designated by Local Governments
B) Public Benefit: Indicate how the donation will protect the conservation purpose(s) identified above and benefit the public.
Indicate which of the following restrictions are included in the deed of donation:
4. Restrictions on the location of
1. Limitations on the number of property divisions.
Yes
No
Yes
No
permitted new roads or access ways.
5. Limitations on alterations, demolition,
2. Limitations on the amount of new buildings and
and ground disturbing activity that
Yes
No
Yes
No
may impact historic, cultural, or natural
structures.
heritage resources.
3. Restrictions on the location of permitted new
6. Limitations on utility placement.
Yes
No
Yes
No
buildings and structures.
7. Please list any other restrictions specifically donated to protect the conservation purposes and to benefit the public.
C) Riparian Buffers: If riparian buffers are required in the deed of easement, then indicate the total length (in
Forested/Vegetated: ______ feet
linear feet) of those that provide at least a 35-foot wide buffer (See instructions for definitions).
No-plow: _______________ feet
D) Land Currently Being Used for Production Agriculture and Silviculture.
Acres
1. Provide an estimate of the number of acres of the land currently being used in production agriculture (See instructions for definition):
2. Provide an estimate of the number of acres of the land currently being used in production silviculture (See instructions for definition):
E) onsite operational Water Quality Best Management Practices.
Does the land have onsite operational best management practices that are designed to reduce the amount of nutrients
Yes No
and sediment entering public waters?
If Yes, indicate which of the following BMPs are being practiced, and whether the terms of the deed of easement require their continued practice.
Agriculture Best Management Practice
Currently Practiced
Deed Requires Continued Practice
1. Nutrient Management Plan Writing and Implementation
2. Cover Crop Practices
3. Livestock Exclusion Practices
4. Riparian Buffer Practices
Silviculture Best Management Practice
5. Streamside Management Zones
6. Forest Roads
7. Stream Crossings
8. Harvest Planning
9.
Other Agriculture or Silviculture BMPs (See instructions for Section D).
Provide appropriate practice number(s):
F) Forest Management: Is the property fully or partially forested?
Yes No
If Yes, is a forest management plan included in the terms of the donation?
Yes No
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