Step 1: Create Farm ID
The Clean Ohio Agricultural Easement Purchase Program (AEPP) application due date has past for the 2017 round of funding. Users are able to view applications but do not have the ability to change and/or submit applications.
LSID:
FarmID:
Landowner's Last Name:
Official Local Sponsor:
County of Easement:
Total Score:
Total Acreage:
Ag Easement Value:
  • Once this step is completed, you will be issued a Farm ID for this applicant.

  • This Farm ID will need to be provided to the local SWCD/NRCS representative in order for them to complete steps 17 and 18 of the application located above and at the top right hand corner of each step.

  • Required fields are noted with an asterisk before each required text box.


Submitted by LSID:
Farm ID:
* Last Name of Landowner Main Contact:
* First Name of Landowner Main Contact:
* Relationship to Landowner:
* Landowner's Home Address:
* City: * State:   * Zip Code: 
* Telephone: Fax:
Alternate Phone:
Email Address:
Re-Enter Landowner Email Address:

Step 2: Local Sponsor
  • Once this step is reviewed and submitted, you will be issued a Farm ID for this applicant.

  • Use this Farm ID to reference each step of the LAEPP application process.

  • This Farm ID will need to be provided to the local SWCD/NRCS representative in order for them to complete steps 17 and 18 of the application.

  • Required fields are noted with an asterisk before each required text box.


* Official Local Sponsor:
* Last Name of Local Sponsor's Representative/Main Contact:
* First Name of Local Sponsor's Representative/Main Contact:
* Relationship to Local Sponsor:
* Local Sponsor's Address:
* City:
* State:
* Zip Code:
* Telephone:
Fax:
Email Address:
Employer:
Title:
Work Address:
City:
State:
Zip Code:
Telephone:
Fax:
Email Address:

Step 3: Eligibility - Required Background Information

The following requirements must be met in order to be eligible to apply for the LAEPP.


3A: Is the land currently enrolled in CAUV in the County Auditor's office?Yes No
3B: Is the land enrolled in the Agricultural District Program with the county auditor?Yes No
3C: If this application covers more than one parcel, are the parcels contiguous per Ohio Administrative Code 901-2-01 (GG)?
(Answering Not Applicable indicates farm is one parcel)
Yes No Not Applicable
3D: Is the farm at least 40 acres in size, or, if less than 40 acres
* Farm is at least 25 acres and is adjacent to farmland already held under a permanent agricultural easement; or
* Farm is at least 25 acres adjacent to protected land compatible with agriculture
(see list of acceptable compatible lands in Question 12B); or
* Farm has applied and been approved for a small farm exception?
Yes No
3E: Does the Local Sponsor have the financial ability to monitor this land for compliance with the terms of the Deed of Agricultural Easement?Yes No
3F: Is the applicant property engaged in any nonagricultural commercial activities?
"Industrial and commercial activities" are prohibited and "Customary Rural Enterprises" are accepted uses; see the Draft Deed of Agricultural Easement.
Yes No
3G: Is the farm entirely located within one county?
If a farm is located within two or more counties, please refer to the "Multi-County Farm Policy" in the Policies and Guidelines.
Yes No
3H: Is the entire farm, including the homestead, included in this application?
(No portion of the applicant farm, including the homestead, may be omitted from the application.)
Yes or Approved Exception No
3I: Are all parcels in this application owned by the same legal entity?
Yes No
3J: Does landowner acknowledge that if selected for easement purchase, that all parcels that make up the application will be bound together by one agricultural easement, and that when sold or transferred in the future, all parcels must be conveyed as one unit (including homesteads)?
Yes No

Step 4: Condition of Use Agreement - Required Background Information

Ohio Department of Agriculture, Office of Farmland Preservation
Copyright Issues and Notification
CONDITIONS OF USE

PLEASE READ THESE TERMS OF USE CAREFULLY BEFORE USING THIS SITE.
 

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The user of this web site and the materials contained herein assents to these terms and conditions by accessing, browsing, or otherwise using this web site and by clicking on the “I Agree” icon at the end of this Notification.

I. PRIVACY
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I (local sponsor) have read and understand the terms outlined in this Conditions of Use Agreement. I agree to abide by the conditions stated in the above agreement. I further agree that I am legally able to make this agreement and accept the terms and conditions outlined in the agreement as written and in its entirety.

I agree and accept the terms of the Conditions of Use Agreement.
I do not accept the terms of the Conditions of Use Agreement and elect not to participate in the Funding Round.

Step 5: Ownership - Required Background Information
5A: Ownership Type:Individual Joint Corporate
Trust Partnership Other
If Individual, list owner(s):
If Joint, list title holders:
If Corporate, Trust or Partnership, entity's Name:
All other types, designate Type:
Designated Authorized Representative:
Designated Authorized Representative:
Designated Authorized Representative:
5B: Does anyone with a ownership interest in this applicant property also have an ownership interest in another property applying for the Funding Round?Yes No
5C: If the answer to 5B is "Yes", identify the other property(ies) or parcel(s) that are applying for the Funding Round in the space provided:
Property Owner 1:
Landowner's Last Name:
First Name:
Acreage:
Property Owner 2:
Landowner's Last Name:
First Name:
Acreage:
Property Owner 3:
Last Name:
First Name:
Acreage:

Step 6: Title Holder(s) - Required Background Information
List all titleholders of the applicant properly.
Landowner 1: Last Name:
First Name:
Middle Initial:
Mailing Address:
City:
State:       Zip Code:  
Landowner 2:Last Name:
First Name:
Middle Initial:
Mailing Address:
City:
State:       Zip Code:  
Landowner 3:Last Name:
First Name:
Middle Initial:
Mailing Address:
City:
State:       Zip Code:  
Landowner 4:Last Name:
First Name:
Middle Initial:
Mailing Address:
City:
State:       Zip Code:  
Landowner 5:Last Name:
First Name:
Middle Initial:
Mailing Address:
City:
State:       Zip Code:  
Landowner 6:
Last Name:
First Name:
Middle Initial:
Mailing Address:
City:
State:
Zip Code:
Landowner 7:
Last Name:
First Name:
Middle Initial:
Mailing Address:
City:
State:
Zip Code:

Step 7: Applicant Farm Address - Required Background Information
* Farm Physical Address:
Post Office Box:
* City:
* State:
* Zip Code:
* County:
* Township:
Township:


Step 8: County Auditor Records - Information Required to Calculate Points Based Appraisal (Step 19)
County Auditor's Tax Records for the application farm **

** NOTE: The per acre value is determined by using 100% of the Market Value of the land (including the homestead property) for each parcel, then dividing the Grand Total by the number of total acres on the farm. The same calculation is used for determining the CAUV, using 100% of its value. Be sure to use appraised value (NOT Assessed). Contact the County Auditor’s Office for information. Values input must be reflected in Attachment C.

Parcel NumberNumber of
Acres
100% CAUV ($)100% Market
Land ($)
100% Buildings
($)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Grand Total
Per Acres Value(s)

Step 9: Farmland Usage
The Clean Ohio Local Agricultural Easement Purchase Program (AEPP) application due date has past for the 2017 round of funding. Users are able to view applications but do not have the ability to change and/or submit applications.     
FarmID:
Landowner's Last Name:
Total Acreage:
Briefly describe the applicant property's agrcultural activities and include a photo of the applicant property as Attachment "K".
Livestock:
Type:Number:
Type:Number:
Type:Number:
Type:Number:
Grain:
Type:Acres:
Type:Acres:
Type:Acres:
Type:Acres:
Pasture Acres:
Woodlot/Forested Acres: *If greater than 50% of the farm, must have a timber management plan.
Homestead Acres:
Nursery Acres:
Greenhouse Acres:
Fruit Acres:
Vegetables Acres:
Aquaculture Quantity:
Christmas Tree Acres:
Tobacco Acres:
CRP/Stream Buffer Acres:
Other Acres:Description:
Other Acres:Description:


Step 10: Third Party Interests - Required Background Information
10A: Likelihood of change or conversion:
- Is the property currently involved in an estate dispute?Yes No
- Has the owner of record recently filed for:Not Applicable Bankruptcy Foreclosure
10B: Current Mortgage Information:
- Is there currently a mortgage(s) or lien(s) on the property? **Yes No
- Is there a court judgment by the State of Ohio, or any agency thereof, against any party with an ownership interest in the LAEPP application property?** Yes No
** Please indicate any tax liens, civil judgment, or environmental findings
If you answer "Yes" to Question 10B, provide the following lender information:
Lien Holder 1 Name:
Contact Person:
Mailing Address:
City:
State:
Zip:
Telephone:
Parcel Number(s) with Lien:
Lien Holder 2 Name:
Contact Person:
Mailing Address:
City:
State:
Zip:
Telephone:
Parcel Number(s) with Lien:
Lien Holder 3 Name:
Contact Person:
Mailing Address:
City:
State:
Zip:
Telephone:
Parcel Number(s) with Lien:
Lien Holder 4 Name:
Contact Person:
Mailing Address:
City:
State:
Zip:
Telephone:
Parcel Number(s) with Lien:
Lien Holder 5 Name:
Contact Person:
Mailing Address:
City:
State:
Zip:
Telephone:
Parcel Number(s) with Lien:

Step 11: Restrictions - Required Background Information
11A: Are there any restrictive covenants, leases, or easements on the applicant property to include:
(Maximum Points = 0.0)
Yes No
Has the applicant property ever had a Surface Mining Lease?
If there is a current lease, it will need to be removed. If there was a past lease, it could affect the property's entrance into the program.
Yes No


Is the applicant property participating in the permanent easement program of the Wetland Reserve Program?Yes No
If "Yes", how many acres are included in the Wetland Reserve Program?


Does the applicant property have a permanent Conservation Easement?Yes No
If "Yes", how many acres are included in the Conservation Easement?


Does the applicant property have a a Utility Easement?Yes No


Is the landowner aware of any past or present oil/gas leases on the title for the applicant property?Yes No


11B: Does the landowner have existing housing (i.e, homestead, personal residence, or tenant house) on the application farm?
(Maximum Points = 0.0)
Yes No
If "Yes", how many?

Step 12: Proximity to Protected Land - Scoring (Maximum Points = 15)
The highest ranking is given to farmland that is located near other protected areas, which ensures a better chance of long term agricultural viability.


Note: Applicants must show entries for Step 12 on Attachment D

12A: The Applicant Farm's physical location relative to other agricultural, natural resource, open space, or forested land permanently protected by an agricultural or conservation easement. List each easement-protected property individually. If none please fill in "None" in Property Type.(Maximum Points = 7.5)
Property TypeAcresProximity in Feet
  Proximity in Feet Legend
Adjacent (Multiplier = 1.0)
Less Than or equal to 3,520 Feet (Multiplier = .75)
Between 3,521 & 7,040 Feet (Multiplier = 0.50)
Between 7,041 & 10,560 Feet (Multiplier = 0.25)

Total Acre Equivalents
Total Acreage Factor
Weighted Multiplier
Points For 12-A
12B: The Applicant Farm's physical location relative to other non-easement protected land compatible with agriculture. These lands include the following: wetlands, public parks, open spaces, forests, airports, military bases, wildlife areas, natural preserves, prison farms, historic or archaeological sites, conservancy parks, reservoirs, well fields, battlefields, flood pools* and other normally undevelopable waterbodies, publicly-owned agricultural research lands, and protected well heads. List each non-easement protected land individually. If none please fill in "None" in Property Type.(Maximum Points = 2.5)
Property TypeAcresProximity in Feet

Note: If property type is “trail,” list
each trail separately and with an acreage
of “10,” regardless of length of trail.
Trail may be counted at its closest point
under “Proximity in Feet.”

  Proximity in Feet Legend
Adjacent (Multiplier = 1.0)
Less Than or equal to 3,520 Feet (Multiplier = .75)
Between 3,521 & 7,040 Feet (Multiplier = 0.50)
Between 7,041 & 10,560 Feet (Multiplier = 0.25)

Total Acre Equivalents
Total Acreage Factor
Weighted Multiplier
Points For 12-B
*Flood Pool - An area of flood-prone land subject to inundation by impounded floodwaters from a flood control structure. For dams with abnormal pool elevation, the lands surrounding this area that are below the elevation of an emergency spillway. This flood pool area is normally protected by a restricted development easement that was negotiated at the time of construction of the flood control structure.

For 12c and 12d, the total points cannot exceed 5.0. The applicant will be given credit for the points awarded for the response to either Question 12c or 12d, but not both, depending on which returns the higher point value. For example, if the applicant earns 3.0 points in Question 12c but only 2.0 points in Question 12d, the applicant will receive 3.0 points.
12C: The Applicant Farm's proximity to two or more adjacent (within 10,560 feet) farms, including the applicant farm, that are applying in this Funding Round to sell an agricultural easement. List each farm individually and list only farms that have also been submitted electronically. If none please fill in "None" in Property Type.(Maximum Points cannot exceed 5.0)
Property TypeAcresProximity in Feet
  Proximity in Feet Legend
Applicant Farm (Multiplier = 1.0)
Adjacent (Multiplier = 1.0)
Less Than or equal to 3,520 Feet (Multiplier = .75)
Between 3,521 & 7,040 Feet (Multiplier = 0.50)
Between 7,041 & 10,560 Feet (Multiplier = 0.25)

Total Acre Equivalents
Total Acreage Factor
Weighted Multiplier
Points For 12-C
-OR-
12D: Single Larger Farm - A single larger farm consisting of 100 acres or more applying to sell an agricultural easement, without any neighbors applying, can receive points under this section because larger farms contribute to a community's farmland preservation efforts.(Maximum Points cannot exceed 5.0)
350 acres or more - 5 points
300 to 349.99 acres - 4 points
200 to 299.99 acres - 3 points
150 to 199.99 acres - 2 points
100 to 149.99 acres - 1 points
Not applicable - 0 points
POINT FOR 12-A:
POINT FOR 12-B:
POINT FOR 12-C or 12-D(whichever is higher):
TOTAL POINTS FOR STEP 12:

Step 13: Development Pressure - Scoring (Maximum Points = 15)
The highest ranking is faced with intermediate development pressure.

Note: Applicants must show entries for Step 13 on Attachments B or D

13A: Select the one item which indicates the applicant property's proximity to nearest publicly available sewer line from the nearest public road frontage boundary of the property using public roadway distance. (Maximum Points = 5.0)
     Sewer access is:
     Within 500 feet or More than 24,000 feet (0 points)
     Between 501 and 1,000 feet or Between 22,001 and 24,000 feet (1 points)
     Between 1,001 and 3,000 feet or Between 20,001 and 22,000 feet (2 points)
     Between 3,001 and 5,000 feet or Between 18,001 and 20,000 feet (3 points)
     Between 5,001 and 7,000 feet or Between 16,001 and 18,000 feet (4 points)
     Between 7,001 and 16,000 feet (5 points)
13B: Select the one item which indicates the applicant property's proximity to nearest publicly available water line from the nearest public frontage boundary of the property using public roadway distance. (Maximum Points = 3.0)
     Water access is:
     Within 500 feet or More than 24,000 feet (0 points)
     Between 501 and 1,000 feet or Between 22,001 and 24,000 feet (1 points)
     Between 1,001 and 3,000 feet or Between 20,001 and 22,000 feet (1.5 points)
     Between 3,001 and 5,000 feet or Between 18,001 and 20,000 feet (2 points)
     Between 5,001 and 7,000 feet or Between 16,001 and 18,000 feet (2.5 points)
     Between 7,001 and 16,000 feet (3 points)
13C: Select the one item which indicates the applicant property’s proximity to any freeway interchange listed on the most current available form of the Ohio Department of Transportation’s official statewide highway map at www.dot.state.oh.us/maps/Pages/default.aspx or other electronic map, to be measured by public roadway distance from the nearest road frontage boundary of the farm property.
(Maximum Points = 2.0)
     Freeway interchange access is:
     Within 1,500 feet or More than 22,001 feet (0 points)
     Between 1,501 and 3,000 feet or Between 20,001 and 22,000 feet (0.5 points)
     Between 3,001 and 5,000 feet or Between 18,001 and 20,000 feet (1 points)
     Between 5,001 and 7,000 feet or Between 16,001 and 18,000 feet (1.5 points)
     Between 7,001 and 16,000 feet (2 points)
13D: Public Road Frontage on the applicant farm. (Maximum Points = 3.0)
     Roadway frontage is:
     Less than 1,000 feet (0 points)
     Between 1,001 and 2,000 feet (1 points)
     Between 2,001 and 3,000 feet (1.5 points)
     Between 3,001 and 4,000 feet (2 points)
     Between 4,001 and 5,000 feet (2.5 points)
     5,001 feet or more (3 points)





13E: How many homes exist within a one-half mile perimeter of the farm boundary? (Maximum Points = 2.0)
     12 homes or less (2 points)
     13 to 24 homes (1.5 points)
     25 to 36 homes (1 points)
     37 to 48 homes (0.5 points)
     More than 48 homes (0 points)
TOTAL POINTS FOR STEP 13:

Step 14: Other Factors - Scoring (Maximum Points = 29)
The highest ranking is given to those other factors that can influence local efforts to preserve farmland including: population growth, historic designation, enrollment in an agricultural security area, historic designation, level of farm and county production, bargain sales of agricultural easements, and established dedication of landowner to keeping land in agriculture.
Other factors that can influence local efforts to preserve farmland include population growth, landowners who enroll in Agricultural Security Area (ASA), farms that have a historical designation, and bargain sales of agricultural easements.
TOTAL POINTS FOR STEP 14:  
Local Match
     60% Local Match
     55% Local Match
     50% Local Match
     45% Local Match
     40% Local Match
     35% Local Match
     30% Local Match
     25% Local Match

Step 15: Local Government's Comprehensive Planning - Scoring (Maximum Points = 16)
The highest ranking is given to farmland that the local government has designated for protection through planning, zoning and other efforts, and has already taken some steps to protect this farmland.
15A: Has the local government adopted a comprehensive land use plan that was written or revised within the past seven years – or – is the farm located within an approved Watershed Balanced Growth Plan also approved by the applicant property’s local government? (Maximum Points = 3.0)
     Yes (3 points)      No (0 points)
15B: Is the applicant property located within a specific area designated for agricultural use by the comprehensive land use plan – or – is the applicant property located within a Priority Conservation Area (PCA) or Priority Agricultural Area (PAA) in an approved Watershed Balanced Growth Plan also approved by the applicant property’s local government? (Maximum Points = 5.0)
     Yes (5 points)      No (0 points)
15C: The applicant property's zoning type allows for no more than one house per: (Maximum Points = 4.0)
     Less than 10 acres, No zoning (0 points)
     10 to 20 acres (1 points)
     21 to 30 acres (2 points)
     31 to 40 acres (3 points)
     41 acres and over (4 points)
15D: How much funding did the local government expend in the previous year for farmland preservation, including administration, planning, education, and/or purchase of agricultural easements? (Maximum Points = 4.0)
Time invested by the local SWCD or regional planning commission may be included if the work was approved and paid for by the local government and was specifically provided for farmland preservation purposes.
     At least $50,000 spent in the previous year. (4 points)
     Between $25,000 and $49,999 was spent in the previous year. (3 points)
     Between $10,001 and $24,999 was spent in the previous year. (2 points)
     Up to $10,000 was spent in the previous year. (1 point)
     No funds were spent for farmland preservation in the previous year. (0 points)

If any of the above were answered, "Yes," then describe the expenditures and how the funds were spent: (Maximum 1300 characters)

     
County or Municipal Planner or Engineer
This individual will need to certify this section with their signature in Step 20.


**Note: This individual must only certify answers to question 15A-C.
*Last Name:
*First Name:
Title:
*Organization:
*Address:
*City:
*State:
*Zip:
*County:
*Telephone:
E-Mail:
TOTAL POINTS FOR STEP 15:

Step 16: Narratives
NOTE: This step is no longer a part of the landowner application.




Step 17: Conservation Plan - Scoring (Maximum Points = 5)
The Conservation Plan documents the applicant farm's best land use practices.
The highest ranking is given to farmland with established and implemented conservation plans.
Representative must sign "Conservation Certification"

To be approved by SWCD or NRCS representative
Landowner Last Name:
Farm Address:
Farm County:
Farm Township:
Total number of acres available for agricultural use:
17A: Has the farmer or landowner implemented one of four types of conservation plans as defined/developed by the Natural Resource Conservation Service (NRCS) or the local Soil & Water Conservation District (SWCD)? Or, if the farm is an organic operation, has a conservation plan been approved by a qualified organization that is acceptable to the Director of ODA? (Maximum Points = 5.0)
Highest ranking is given to the landowners with established and implemented conservation plans. Select conservation type:
     The Landowner has established and is implementing a complete whole farm plan that addresses all resource concerns, as defined by USDA/NRCS.(5 Points)
     The Landowner has established and is implementing a plan that addresses multiple resources, but not all resource concerns.(3 points)
     The Landowner has established and is implementing a plan that addresses a single resource, such as a Highly Erodible Land Plan.  (2 Points)
     The farm does not have a conservation plan. (0 Points)
Conservation plan’s date of last revision (Enter the Date: MM/DD/YYYY): 
17B: Conservation Plan Certification
This individual will need to certify this section with their signature in Step 20.
* Last Name:
* First Name:
Title:
Organization:
* Telephone:
Email:
TOTAL POINTS FOR STEP 17:

Step 18: Soil Type Productivity - Scoring (Maximum Points = 20)
The highest ranking is given to farmland with those soils designated as prime, unique, locally important.
Representative must sign "Soils Certification"

TO BE APPROVED BY SWCD REPRESENTATIVE ONLY
Points will be based on prime soil, unique, or locally important soils. A score between 0 and 20 will be calculated based on the completion of the Soils Worksheet below. All soils, including homestead, should be listed.

Note: Total acres reported in this step must be within 3% of the Total Acreage reflected in Step 8, less any permanent easement acres reflected in Step 11.
Please prepare an 8-1/2 x 11 Soils Map and Soils Legend with the farm's outer boundary outlined and attach to the application.
Please complete the Soils Worksheet below for the applicant farm listed above.
Map SymbolMap Unit Name# of AcresProductivity Index *Soil Designation **Weighted
Score
Total Acres: Total Weighted Score:
Total Weighted Score/Total Acres:

* Productivity Index is from OSU Bulletin #685, Ohio Soils With Yield Data and Productivity Index, 1983.  To view latest soil listing, click here.
** Soils Designations are available in NRCS Technical Guide for County.
*** Soil Type and Acreage can be found utilizing the Natural Resources Conservation Service's Web Soil Survey.

BONUS FOR UNIQUE OR LOCALLY IMPORTANT (non-prime farmland): Bonus points are awarded for unique or locally important farmland engaged in agricultural activities. A total of up to 5 bonus points is awarded, based on 1 bonus point for each 20% increment of the farm's acreage so engaged. For example, if a 100-acre farm has up to 20 acres of unique or locally important farmland, it would be awarded 1 bonus point; 21 to 40 acres of such farmland, it would be awarded 2 bonus points, etc. Bonus points added to the Soil Type and Productivity Worksheet total cannot exceed a Grand Total of 20 points. County Soil and Water Conservation Districts must verify eligibility, acres & points.
(Cannot exceed 5 bonus points) BONUS TOTAL:
(Cannot exceed maximum 20 points) GRAND TOTAL:

Step 19: Points Based Appraisal

- How we determine your farm's value

- Worksheet to check your values

- View County Listing (adjusted land value for Item 2)

1. ODA Agricultural Easement Base:
     a. Market Value
     b. CAUV
     c. ODA Agricultural Easement Base (per acre value)
2. ODA Adjusted Land Value
3. First Adjusted ODA Ag Easement Value Calculation
4. First Adjusted ODA Ag Easement Value
5. ODA Total Score
     a. Points Above "60"
     b. ODA Ranking System Farmland Preservation Points
6. Second Adjusted ODA Ag Easement Value Calculation
7. Second Adjusted ODA Ag Easement Value
8. Local Match/Donation
9. Local Match/Donation Calculation
10. Final Adjusted ODA Ag Easement Value(Cannot exceed $2,000 per acre)
11. Total Amount of Farm's Acres, including Homestead Acres (excluding easements)
12. MAXIMUM TOTAL PURCHASE PRICE OF THIS AGRICULTURAL EASEMENT (Cannot exceed $500,000)

Step 20: Certifications






All parties are responsible for the information included within this application.

This signature page can be printed with the entire submitted application on the next page. This printed out page MUST be signed by appropriate parties and submitted with the entire printout of the electronically submitted LAEPP application. Any inaccuracies or incompleteness regarding the application is grounds for the ODA to invalidate the application.
Landowner(s): All individuals who own an interest in the applicant farm, or are authorized to act on behalf of landowner(s), must be listed in the Title Holder section of this application and sign below in order for the State of Ohio to consider this application.

I/We verify and attest that the statements submitted in the application are a true and accurate representation of the facts regarding my/our farm. It is understood that my/our signature does not obligate sale of an Agricultural Easement on my/our farm, but simply permits the State to consider purchase of the Agricultural Easement. I/we also understand that all information surrounding my/our farm’s involvement with the Clean Ohio Local Agricultural Easement Purchase Program will be made available as required under Ohio’s Public Records law (i.e., Chapter 149 of the Ohio Revised Code). Further, to the best of my/our knowledge, no environmental hazards exist on the property and I/we affirm that I/we have been in substantial compliance with all federal, state and local agricultural laws for the past five years.

My signature below also represents that I understand and acknowledge the following key information below:

  • My property may also be submitted to the Agricultural Conservation Easement Program (ACEP) through the United States Department of Agriculture, Natural Resources Conservation Service. Participation and assistance for additional information, etc. may be requested in a timely manner. This includes extinguishment of historic oil and gas leases, contracting for a professional appraisal according to USDA specifications, and the completion of USDA’s forms.
    More information available at: http://www.nrcs.usda.gov/wps/portal/nrcs/main/oh/programs/easements/acep/
  • I may be required to pay and arrange for a property survey;
  • I will be responsible for clearing and/or subordinating all interests that limit the title of a property, which include but are not limited to mortgages, leases, liens, restrictions, or legal or equitable interests. I am responsible for all associated costs with these items and am responsible for ensuring that this occurs within a timely manner.
  • I have read a recent sample Deed of Agricultural Easement and am aware of the Reserved Rights and Prohibited Uses/Restrictions that I would need to agree to in order to participate in the program and that the Deed of Agriculture Easement is subject to change prior to closing;
  • Subdividing of a protected property is prohibited within the deed restrictions regardless of the number of parcels included within the application. All parcels that make up the application property will be bound together by one permanent agricultural easement. In the future, if the land under easement is sold or transferred, all parcels must be conveyed as one unit and cannot be sold or transferred separately.
  • One homestead may be reserved if no housing currently exists on the applicant property. This reservation allows for one-single family home to be built in the future. If housing exists on the property at the time of application, then no additional residences may be built;
  • My property currently is and I will work so that it can continue to be a good showcase for the promotion of farmland preservation in Ohio;
  • I am strongly encouraged by the Ohio Department of Agriculture to seek professional financial/tax advice as well as legal advice.
  • This is not a comprehensive list of the program’s requirements/expectations of the landowners, but references the most common concerns of past participants.

Title Holder(s):

SIGNATURE:

DATE:

 

SIGNATURE:

DATE:

 

SIGNATURE:

DATE:

 

SIGNATURE:

DATE:

 

SIGNATURE:

DATE:

 

SIGNATURE:

DATE:

 

SIGNATURE:

DATE:


Sponsor representative:  I verify that to the best of my knowledge all information contained in this application is true and accurate, including the reported distances and other figures provided, and I am acting as the authorized representative of the local sponsor. As the Local Sponsor, I agree to have the organization/political subdivision named as the local holder of the deed of agricultural easement and share legal responsibility to monitor, supervise, and enforce the provisions of the easement.

NAME: 

ORGANIZATION: 

TITLE: 

SIGNATURE:

DATE:


Conservation Certification:  I certify that all information contained in the  “Conservation Plan" (Step 17) is true and accurate.

NAME: 

SIGNATURE:

DATE:

 

Soils Certification:  I certify that all information contained in the Soils Worksheet (Step 18), is true and accurate. I further verify that the soils map and soils legend are included as Attachment E  and the content of Attachment E  is also true and accurate.

NAME: 

SIGNATURE:

DATE:


County or Municipal Planner or Engineer:  I certify that the Local Government Comprehensive Planning section (Step 15) and all reported distances within the application are accurate and complete.

NAME: 

SIGNATURE:

DATE:


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Attachment Checklist

This attachment checklist completes the Clean LAEPP online application. Attach the following items labeled clearly to the printed online application for submission to ODA (see Local Sponsor Cooperative Agreement for details). The application may be deemed incomplete if applicable attachments are not submitted to ODA, and any inaccuracies or incompleteness regarding the application is grounds for ODA to invalidate the application.

Applications submitted to ODA for final funding approval must be printed out and submitted by hard copy with signatures and attachments within ten (10) business days of the close of the Local Sponsor's landowner application period, but in no event later than April 30, 2015. Applications may be submitted to ODA in person or by mail at the Office of Farmland Preservation, 8995 East Main Street, Reynoldsburg, Ohio 43068.

Note: Examples of attachments can be found on the Clean Ohio LAEPP under "Landowner Application Information".

ATTACHMENT A: Resolution

Attach a resolution or ordinance from the political subdivision or a recorded action from a soil and water conservation district, charitable organization supporting the landowner’s application, certifying the availability and committing to pay the required local match (if applicable), and agreeing to monitor, supervise and enforce the deed of agricultural easement on behalf of the director.

ATTACHMENT B: Farm Map

An 8 ½ x 11 inch map or aerial photograph of the application property, including:

1.) Delineated existing or reserved homestead area(s);
2.) Existing roads and buildings;
3.) Boundaries;
4.) Total road frontage of the farm;
5.) Power easements; and
6.) Any land excluded from the easement.

ATTACHMENT C: County Auditor Records

Provide County Auditor tax records and a map of the applicant farm's land values used in responding to Step 8 of this application e.g., the real estate taxes and assessments (tax bill), or other real property records. Be sure to include the most recent documentation showing:

1.) Market Value of the application by tax parcel
2.) CAUV enrollment
3.) Agricultural District enrollment

ATTACHMENT D: Aerial

Include an 8 ½ x 11 inch map, sketch, or aerial photograph showing an adequate radius of the application property. Include information claimed in Step 12 and questions 13A, 13B, 13C, and 13E. This includes, but is not limited to the proximity of the application farm from any protected properties (easement and non-easement), to neighboring applicant farms, distance to sewer and water, interchanges, pipelines, and accessible public roadway intersection(s).

ATTACHMENT E: Soils Map

Include an 8 1/2 x 11 inch coded soils map containing a list of soil mapping unit names and symbols.

ATTACHMENT F: Historical Designation (if applicable)

For land or structures that have been historically designated and received points for question 14C, attach written verification from the respective designating authority confirming that the land or building is significant and when it was designated as such.

ATTACHMENT G: Corporations, Partnerships, and Trusts (if applicable)

If the applicant property’s ownership consists of a corporation, partnership, and/or trust the following must be provided:

1.) A copy of incorporation papers, and
2.) Certificate of authorization that the individual is authorized to act on behalf of the Corporation,
Partnership, or Trust.

ATTACHMENT H: Charitable Organizations (if applicable)

If the local sponsor is a charitable organization, it must be tax exempt and be organized for the purpose of the preservation of agricultural land. To demonstrate this, the organization must provide:

1.) A copy of the organization’s exemption under 26 U.S.C. 1, subsection 501(a) and 501(c).
2.) A statement of the organization’s stewardship endowment policy.
3.) An ordinance or resolution supporting the agricultural easement from the township(s) and county(ies) where the applicant property is located.


*NOTE: If Local Sponsor previously submitted Attachment H Items 1 and 2 with their Local Sponsor Application for Certification, Please
include a page that states that these items where previously submitted as such. Item Number 3(Resolutions) is still required for
every hard copy Landowner Application submitted to ODA for final approval.

The Director of the Ohio Department of Agriculture may ask a charitable organization for the following
additional information:

(a) A copy of the organization’s by-laws or regulations stating that farmland preservation is one of its purposes.
(b) A list of the organization’s officers, board of directors, and members;
(c) The organization’s financial condition, including a balance sheet, revenue and expense
statement, and the financing available for monitoring and enforcing an agricultural easement;

(d) The organization’s ability to provide the necessary managerial, legal and financial expertise to
hold, monitor, and enforce an agricultural easement.

ATTACHMENT I: ASA Enrollment Verification (if applicable)

If the application claims that the applicant property is enrolled in an ASA within Question 14B, the resolution(s) approving the enrollment must be attached.

ATTACHMENT J: Current Owner’s Deed of Record

Provide a copy of the current owner’s deed of record. Include the most current deed reference book, volume and page or other reference to the place of record of the deed. In the case of multiple deeds, numbers for all the deeds should be provided.

ATTACHMENT K: Site Visit Form

Include site visit form for LAEPP 2015 Landowner Aplication, available on the Clean Ohio LAEPP main webpage under Landowner Application Information or from the left-hand menu of the Landowner Application website. Site Visit form must include at least one landowner's initials and signature, as well as a Local Sponsor signature.

ATTACHMENT L: Photo of Property / Any other additional information

1.) Provide a photo of the applicant property.
2.) Additional information may be attached such as the Large or Small Farm Exception Letter (if applicable).
3.) According to the OAC 901-2-07(D)(5), applicants may provide photos, maps, or other visual aids not to exceed page and size limits set by the Local Sponsor.