Riparian Zone Grazing Exclusion Waiver
Landowner Information
Name
Address
Phone
Email
Property Information
Property Location / Legal Description
Parcel Number
Watercourse/Stream Name
Grazing Exclusion Details
Area to be Excluded from Grazing
Duration of Exclusion
Reason for Waiver Request
Proposed Management Practices
Agreement
Landowner Signature
Date
Agency Representative Signature
Date