Title Page
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Landowner
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Job Number
Tū te Manawa Freshwater Grant Application Form
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Type of Application Form
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Environmental Management Officer
- Lucy Ferguson
- Anna Regtien
- Anna Monk
- Clare Ridler
- Joe Martin
- Other
Applicant details
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Applicant Name
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Postal Address
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Telephone Number
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Cellphone Number
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Email Address
Proposed Works
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Year of proposed works
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Location of works
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Photo of work area
Fencing
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Fencing
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Type of fencing
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Length (m)
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Rate/m ($)
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More fencing
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Type of fencing
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Length (m)
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Rate/m ($)
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Total fencing cost ($)
Plants
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Plants
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Number of plants required
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Average cost per plant ($)
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Estimated plant purchase cost ($)
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Cost per plant for planting and spot spraying
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Cost of planting and spot spraying ($)
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Suitable plant species
- Swamp Flax
- Mt Flax
- Cabbage Tree
- Carex secta
- Carex virgata
- Toetoe
- Karamu
- Koromiko/ Hebe
- Manuka
- Mingimingi
- Olearia solandri
- Olearia virgata
- Five-finger
- Kahikatea
- Kanuka
- Kohuhu
- Kowhai
- Lemonwood
- Lacebark
- Ribbonwood
- Red matipo
- Broadleaf
- Totara
- Rimu
- Lancewood
- Other
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Other plants
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Total planting cost ($)
Other
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Other
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Total cost of other ($)
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Other costs
- Fenceline Prep
- Earthworks
- Fishpass
- Structures
- Weed Control
- Troughs
- Gates
- Other
Total Estimated Costs
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Total estimated cost (excl. GST)
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Grant rate (%)
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Estimated grant (excl. GST)
Technical Criteria and Justification of Work
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Farm type
- Sheep/Beef
- Dairy
- Dairy Runoff
- Deer
- Lifestyle
- Bull Beef
- Heifer Grazing
- Other
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Water management zone
- Mana_1a
- Mana_1b
- Mana_1c
- Mana_2a
- Mana_2b
- Mana_3
- Mana_4
- Mana_5a
- Mana_5b
- Mana_5c
- Mana_5d
- Mana_5e
- Mana_6
- Mana_7a
- Mana_7b
- Mana_7c
- Mana_7d
- Mana_7e
- Mana_8a
- Mana_8b
- Mana_8c
- Mana_8d
- Mana_9a
- Mana_9b
- Mana_9c
- Mana_9d
- Mana_9e
- Mana_10a
- Mana_10b
- Mana_10c
- Mana_10d
- Mana_10e
- Mana_11a
- Mana_11b
- Mana_11c
- Mana_11d
- Mana_11e
- Mana_12a
- Mana_12b
- Mana_12c
- Mana_12d
- Mana_12e
- Mana_13a
- Mana_13b
- Mana_13c
- Mana_13d
- Mana_13e
- Mana_13f
- Rang_1
- Rang_2
- Rang_3
- Rang_4
- Whai_1
- Whai_2
- Whai_3
- Whai_4
- Whai_5
- Whai_6
- Whai_7
- Whau_1
- Whau_2
- Whau_3
- Whau_4
- Tura_1
- Ohau_1
- Owha_1
- East_1
- Akit_1
- West_1
- West_2
- West_3
- West_4
- West_5
- West_6
- West_7
- West_8
- West_9
- Hoki_1
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Catchment/Stream Name
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Justification of work
Risk Management
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Risks to proposed works, including pest plants and animals. Identify likely threats, outline who will control them and how (e.g. Weeds, pest animals, releasing of riparian plants, flooding).
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Access to site (are there any risks involved in site access? I.e. Steep inclines, rough tracks, bridges)
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Who is undertaking the work? (Are they qualified and/or experienced for the type of work to be done?)
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What risks are they bringing onto the site? (I.e. Equipment, chemicals, heavy machinery)
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What risks are there on the property that people coming onsite need to know about? (I.e. Waterways, unstable banks, animals, sprayed areas)
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How will people coming onto the property be told about the risks? (I.e.briefings, site safety plans, signage)
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What communication options will stakeholders use while onsite and will be available if there is an emergency? (I.e. Cell phone coverage, VHF, UHF, PLB, mobile data).
Declaration
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I hereby understand that the payment of funds is dependent upon the completion of the work in accordance with the summary noted above. I have fully participated in risk management discussions and will undertake actions outlined above. I agree to maintain and manage the above works in a manner that will enable them to continue to meet the objectives for the grant provided. I understand that any work undertaken prior to notificaion of financial approval is done at my own risk.
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Signature of Applicant
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Signature of Environmental Management Officer
Administration
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Signature of Manager
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Job Number
