Secure Rural Schools and Community Self-Determination Act of 2000
Public Law 106-393
Title II Project Submission Form
USDA Forest Service 
Siskiyou Oregon RAC

	Name of Resource Advisory Committee: Siskiyou OR
	Project Number (Assigned by Designated Federal Official): 
	Funding Fiscal Year(s): 2009

2. Project Name: 	3a. State:
3b. County(s):  	
4. Project Submitted By: 	5. Date:  	
6. Contact Phone Number: 	7. Contact E-mail:	

8. Project Location:	
a.  National Forest(s):	b. Forest Service District:	
c.  Location (Township-Range-Section)	

9. Project Goals and Objectives:  

10. Project Description: 
a. Brief: (in one sentence)

b. Detailed:

11. Types of Lands Involved?	
State/Private/Other lands involved?  Yes      No
Land Status:	
If Yes, specify:	

12. How does the proposed project meet purposes of the Legislation? (Check at least 1)	
 Improves maintenance of existing infrastructure. 	
 Implements stewardship objectives that enhance forest ecosystems.  	
 Restores and improves land health. 	
 Restores water quality	

13.  Project Type
a.  Check all that apply:  (check at least 1) 	
 Road Maintenance 	 Trail Maintenance 	
 Road Decommission/Obliteration 	 Trail Obliteration 	
 Other Infrastructure Maintenance (specify):	
 Soil Productivity Improvement 	 Forest Health Improvement 	
 Watershed Restoration & Maintenance	 Wildlife Habitat Restoration 	
 Fish Habitat Restoration 	 Control of Noxious Weeds 	
 Reestablish Native Species 	 Fuels Management/Fire Prevention	
 Community Economic Benefit	 Other Project Type (specify):	
b. Primary Purpose (select only 1):	

14.  Identify What the Project Will Accomplish 	
Miles of road maintained:	
Miles of road decommissioned/obliterated:	
Number of structures maintained/improved: 	
Acres of soil productivity improved: 	
Miles of stream/river restored/improved: 	
Miles of fish habitat restored/improved: 	
Acres of native species reestablished: 	
Miles of trail maintained: 	
Miles of trial obliterated: 	
Acres of forest health improved (including fuels reduction): 	
Acres of rangeland improved: 	
Acres of wildlife habitat restored/improved: 	
Acres of noxious weeds controlled: 	
Timber volume generated: 	
Number of jobs generated: 	
People reached (for environmental education projects/fire prevention): 	
Direct economic activity benefit: 	
Other: 	

15. Estimated Project Start Date: 	16. Estimated Project Completion Date: 	

17.  How will cooperative relationships among people that use federal lands be improved?  List known partnerships or collaborative opportunities. 

18.  How is this project in the best interest of the community? Identify benefits to communities. 

19.  How does the project benefit federal lands/resources?  

20.  What is the Proposed Method(s) of Accomplishment? (check at least 1)	
 Contract	 Federal Workforce	
 County Workforce	 Volunteers	
 Grant	 Agreement	
 Americorps	 CCC Crews	
 Other (specify): 	

21.  Will the Project Generate Merchantable Materials?	 Yes		 No

22. Anticipated Project Costs 	
a.  Title II Funds Requested: 	
b. Is this a multi-year funding request?  Yes   No     If yes only include request for 2009	

23. Identify Source(s) of Other Funding: 

24.  Monitoring Plan  
a.	Provide a plan that describes your process for tracking and explaining the effects of this project on your environmental and community goals outlined above.

b.	Identify who will conduct the monitoring:

c.	Identify total funding needed to carry out specified monitoring tasks (Cost Worksheet 1, Item k):

25. Identify remedies for failure to comply with the terms of the agreement.
If project cannot be completed under the terms of this agreement:
  Unused funds will be returned to the RAC account. 
  Other, please explain:

	

Project Cost Analysis Worksheet
Worksheet 1
Please submit this worksheet with your proposal

Item	Column A
Fed. Agency
Appropriated
Contribution	Column B
Requested
Title II
Contribution	Column C
Other
Contributions	Column D
Total
Available
Funds	
a. Field Work & Site Surveys					
b. NEPA/CEQA					
c. ESA Consultation					
d. Permit Acquisition					
e. Project Design & Engineering					
f. Contract/Grant Preparation 					
g. Contract/Grant Administration					
h. Contract/Grant Cost					
i.  Salaries					
j. Materials & Supplies					
k. Monitoring					
l. Other					
m. Project Sub-Total					
n. Indirect Costs FS 12.5%					
o. Total Cost Estimate					

NOTES:
a. 	Pre-NEPA Costs
g. 	Includes Contracting/Grant Officer Representative (COR) costs.  Excludes Contracting/Grant Officer costs.
i. 	Cost of implementing project
l. 	Examples include overhead charges from other partners, vehicles use, equipment rentals, travel, etc.
n.	Forest Service indirect cost is approved by the RAC at 12.5%