Restoration Project Submittal Form

Natural Resource Damage Assessment Restoration Project Submittal Form

Please fill in the fields below. Required fields are marked with (*) asterisk symbol, and instructional tips can be read by hovering over each field name. After submittal, an email notification will be sent to the contact email provided. The email will include a printable copy of your project submittal. If you do not want to submit this form electronically, click here to download the pdf version of the restoration project submittal form to mail to LOSCO office.

Contact First Name:*		Contact Email:*
Contact Last Name:*		Contact Phone:*
Contact Title: *		Contact Fax:
Contact Address: *		Contact City:*
Contact State:*		Contact Zip:*
Organization Name: *		Organization Type: *
Organization Web Page:
Project Name: *		Project Location:
Parish (multiple selections allowed)	Acadia Allen Ascension Assumption Avoyelles Beauregard Bienville Bossier Caddo Calcasieu Caldwell Cameron Catahoula Claiborne Concordia DeSoto East Baton Rouge East Carroll East Feliciana Evangeline Franklin Grant Iberia Iberville Jackson Jefferson Jefferson Davis Lafayette Lafourche La Salle Lincoln Livingston Madison Morehouse Natchitoches Ouachita Orleans Plaquemines Pointe Coupee Rapides Red River Richland Sabine St Bernard St Charles St Helena St James St John the Baptist St Landry St Martin St Mary St Tammany Tangipahoa Tensas Terrebonne Union Vermilion Vernon Washington Webster West Baton Rouge West Carroll West Feliciana Winn Coastwide Basinwide Gulfwide	Region: * (multiple selections allowed) click here to view region map	R1 - Region 1 R2 - Region 2 R3 - Region 3 R4 - Region 4 R5 - Region 5 R6 - Region 6 R7 - Region 7 R8 - Region 8 R9 - Region 9 CW - Coastwide
Latitude (dd):		Basin:
Longitude (dd):		Estimated Project Cost:

Restoration Activity:

Project Size:

Affected Area:

Resource/Habitat/Service:

Restoration Result:

Marine/Estuarine Wetland

Freshwater Wetland

Reef

Biological(Fish, Birds, Wildlife)

Upland

Recreational

Other

Creation

Rehabilitation

Enhancement

Protection

Other

Project Status: (please provide as much information as is currently available)

Activity	Funded?	Completed?
Planning/Design/Permitting	YesNon/a	YesNon/a
Property or Resource Acquisition	YesNon/a	YesNon/a
Construction	YesNon/a	YesNon/a
Maintenance and Future Activities	YesNon/a	YesNon/a
Future Construction and Oversight	YesNon/a	YesNon/a
Restoration Monitoring	YesNon/a	YesNon/a
Conservation Servitude/Easement		YesNon/a
Other	YesNon/a	YesNon/a

Restoration Description and Benefits:

Project Partners:

Contact First Name:		Contact Email:
Contact Last Name:		Contact Phone:
Contact Title:		Contact Fax:
Contact Address:		Contact City:
Contact State:		Contact Zip:
Organization Name: *		Organization Web Page:
Organization Type:		Project Involvement:

Attachments: (please upload documentation to describe the restoration project)