Form 10-903 Land and Water Conservatin Fund Description and Notifica

LAND AND WATER CONSERVATION FUND
DESCRIPTION AND NOTIFICATION FORM

(OMB No. 1024-0031, May 31, 2007)

State

Grant #

Amend #

Date Received

Date Approved

Expiration Date

Start Date

Grant Name:
Element Name:
Sponsor Name:
Address:
A = Acquisition
P = Planning
D = New development
C = Combination
R = Renovation development M = Administration

Type

Acreage

Financial

Acquired

Data

Donated

Sponsor

Acres

L = Local
C = C ounty
S = State

Acquisition Assistance

Estimates:
Total

Number of Park Sites*

Source

Cost

Fund

Amount

Of

Match:

Fed

State

Local

PARK INFORMATION
County Name

City Name

GPS Coordinates
(Deg./Min./Sec./Dir.)

Latitude

Park Name #1:

Prior LWCF Assistance?
Fiscal Year

Yes

No

New 6(f) Acres at Park

2007

And/Or

Cong Dist.

Zip Code

Longitude

Enhanced 6(f) Acres at Park
(Previously protected acres receiving development assistance by
this action)

Total Number of 6(f)
Acres at Park

SPECIAL INDICES
)A. Lease land - private

G. Lands transferred to federal agency

B. Leased land - federal

I. Indian sponsored

O. National Heritage Areas

V. American Heritage Rivers

C. Coastal Grant

J. National Historic Register property

Q. Railroad - R-O-W

W. Wetlands

D. Leased land - expired lease
E. Former federal surplus property
F. Flood plain

K. National Natural Landmarks
L. Less than fee acquisition
M. Mined land

R. National river
S. School park
T. National trail

X. Grant involved conversion
Y. Endangered species
Z. Contingency reserve

A. 00. CAMPGROUNDS
01. Tent sites
02. RV/ camp sites
03. Group camp ground
04. Day camp

D. 00. GOLF COURSE
01. Regular 18 hole
02. Par 3
03. Driving range
04. Regular 9 hole
05. Miniature golf
06. Pitch and putt

H. 00. TRAILS
01. Hiking
02. Horse
03. Bicycle
04. Motorized
05. Natural
06. Exercise

E. 00. SWIMMING FACILITIES
01. Pool
02. Wading pool
03. Spray pool
04. Swimming beach
05. Bathhouse

J. 00. WINTER SPORTS FACILITIES
01. Ski lift
02. Ski slope
03. Ski jump
04. Sled/toboggan run
05. Skating rink
06. Ski trails
07. Snowmobile trails
08. Warming huts

N. National Historic Landmarks

U. Utility - R-O-W

FACILITY CODES

B. 00. PICNIC AREAS
01. Family site
02. Group shelter
C. 00. SPORTS & PLAYFIELDS
01. General purpose playfields
02. Baseball
03. Football
04. Tot lot/playground
05. Tennis courts
06. Basketball
07. Rifle/pistol range
08. Trap/skeet field
09. Archery range
10. Rodeo area
11. Track facility
12. Skate board
13. Soccer
14. Other courts
15. Softball

F. 00. BOATING FACILITIES
01. Launch ramp
02. Berths
03. Boat lift
G. 00. FISHING FACILITIES
01. Pier
03 02. Stream improvement
03. Fishing access

P. 00. PASSIVE PARKS
Q. 00. SUPPORT FACILITY
01. Walkways
02. Site improvement/landscaping
03. Utilities
04. Equipment
05. Roads
06. Parking
07. Lighting
08. Signs
09. Comfort station
10. Concession building
11. Maintenance building
R. 00. AMPHITHEATER/ BAND SHELL

K. 00. ENCLOSED SHELTER
01. Pool
02. Courts
03. Picnic

S. 00. LAKE IMPOUNDMENT
T. 00. VISITOR INFORMATION CENTER

L. 00. SHELTERED ICE RINK

U. 00. INTERPRETIVE CENTER

M. 00. HUNTING

V. 00. OTHER

*Attach continuation sheet(s) for grants with 2 or more sites (one per additional site)
NPS 10-903 (Oct. 2004)

N. 00. NATURAL AREA

LAND AND WATER CONSERVATION FUND
DESCRIPTION AND NOTIFICATION FORM
(Continuation Sheet)

(OMB No. 1024-0031, May 31, 2007)

Grant #

Amend #

Cong Dist.

Zip Code

PARK INFORMATION
Park Name #

Prior LWCF Assistance?
Fiscal Year

County Name

City Name

GPS Coordinates
(Deg./Min./Sec./Dir.)

Latitude

:

Yes

No

New 6(f) Acres at Park
And/Or

Longitude

Enhanced 6(f) Acres at Park
(Previously protected acres receiving development assistance by
this action )

Total Number of 6(f)
Acres at Park

2007
SPECIAL INDICES
A. Lease land - private

G. Lands transferred to federal agency

N. National Historic Landmarks

B. Leased land - federal

I. Indian sponsored

O. National Heritage Areas

U. Utility - R-O-W
V. American Heritage Rivers

C. Coastal Grant

J. National Historic Register property

Q. Railroad - R-O-W

W. Wetlands

D. Leased land - expired lease
E. Former federal surplus property
F. Flood plain

K. National Natural Landmarks
L. Less than fee acquisition
M. Mined land

R. National river
S. School park
T. National trail

X. Grant involved conversion
Y. Endangered species
Z. Contingency reserve

A. 00. CAMPGROUNDS
01. Tent sites
02. RV/ camp sites
03. Group camp ground
04. Day camp

D. 00. GOLF COURSE
01. Regular 18 hole
02. Par 3
03. Driving range
04. Regular 9 hole
05. Miniature golf
06. Pitch and putt

H. 00. TRAILS
01. Hiking
02. Horse
03. Bicycle
04. Motorized
05. Natural
06. Exercise

E. 00. SWIMMING FACILITIES
01. Pool
02. Wading pool
03. Spray pool
04. Swimming beach
05. Bathhouse

J. 00. WINTER SPORTS FACILITIES
01. Ski lift
02. Ski slope
03. Ski jump
04. Sled/toboggan run
05. Skating rink
06. Ski trails
07. Snowmobile trails
08. Warming huts

FACILITY CODES

B. 00. PICNIC AREAS
01. Family site
02. Group shelter
C. 00. SPORTS & PLAYFIELDS
01. General purpose playfields
02. Baseball
03. Football
04. Tot lot/playground
05. Tennis courts
06. Basketball
07. Rifle/pistol range
08. Trap/skeet field
09. Archery range
10. Rodeo area
11. Track facility
12. Skate board
13. Soccer
14. Other courts
15. Softball

F. 00. BOATING FACILITIES
01. Launch ramp
02. Berths
03. Boat lift
G. 00. FISHING FACILITIES
01. Pier
03 02. Stream improvement
03. Fishing access

N. 00. NATURAL AREA
P. 00. PASSIVE PARKS
Q. 00. SUPPORT FACILITY
01. Walkways
02. Site improvement/landscaping
03. Utilities
04. Equipment
05. Roads
06. Parking
07. Lighting
08. Signs
09. Comfort station
10. Concession building
11. Maintenance building
R. 00. AMPHITHEATER/ BAND SHELL

K. 00. ENCLOSED SHELTER
01. Pool
02. Courts
03. Picnic

S. 00. LAKE IMPOUNDMENT
T. 00. VISITOR INFORMATION CENTER

L. 00. SHELTERED ICE RINK

U. 00. INTERPRETIVE CENTER

M. 00. HUNTING

V. 00. OTHER

____________________________________________________________________________________________________________________________________________________________
Estimated Burden Statement: The public reporting burden for this collection of inforamation is estimated to average 1 hour per response including time for reviewing instructions,
gathering and maintaining data, and completing and reviewing the form. Direct comments regarding this burden estimate or any aspect of this form should be sent to the National Park Service,
State and Local Assistance Programs Division, 1849 C Street NW, Washington, DC 20240.
Paperwork Reduction Act Statement: This form is necessary to provide data input into an NPS project database which provides timely data on projects funded over the life of the program.
Such data is used to monitor project progress and to analyze program trends. A Federal Agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Any comments on the burden estimate or other aspects of this collection of information may be addressed to the
National Park Service, State and Local Assistance Programs Division, 1849 C Street NW, Washington, DC 20240.

NPS 10-903 (Oct. 2004)