* All ranking dates are proposed and subject to final approval by the County Manager's Office and Board of County Commissioners. Applications submitted by the cycle deadline are not guaranteed ranking within the cycle.

 

** Properties outside of Target Protection Mailing Areas that are larger than 50 acres may take more than six months for review, especially if seasonally wet. Such properties will need to be evaluated during the wet and dry seasons.

 

1

Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com

	Tax ID (Folio Number)	Parcel Size (acres)	Asking Price $
Parcel 1	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com
Parcel 2	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com
Parcel 3	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com
Parcel 4	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com
Parcel 5	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com	Property Description: Please list the following information for each parcel included in your application with a unique Tax ID#. Parcel information can be found on the Collier County Property Appraiser Website at www.collierappraiser.com

2

If more than 5 parcels, please upload a list of Tax IDs (Folio #s), Acreage, and Appraisal Value for all parcels included in this application

If more than 5 parcels, please upload a list of Tax IDs (Folio #s), Acreage, and Appraisal Value for all parcels included in this application Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt, .mp3, .mp4, .mov, .wmv, .avi, .flv

3

Owner's Representative

 *

Owner's Representative

Name:

Address:

Phone: ext.

Email:

4

Property Owners. Please list all owners of record or documented Trustee (s)

	Name:	Address:	Phone:	Email:
Owner/ Trustee	Property Owners. Please list all owners of record or documented Trustee (s)	Property Owners. Please list all owners of record or documented Trustee (s)	Property Owners. Please list all owners of record or documented Trustee (s)ext.	Property Owners. Please list all owners of record or documented Trustee (s)
Owner/ Trustee	Property Owners. Please list all owners of record or documented Trustee (s)	Property Owners. Please list all owners of record or documented Trustee (s)	Property Owners. Please list all owners of record or documented Trustee (s)ext.	Property Owners. Please list all owners of record or documented Trustee (s)
Owner/ Trustee	Property Owners. Please list all owners of record or documented Trustee (s)	Property Owners. Please list all owners of record or documented Trustee (s)	Property Owners. Please list all owners of record or documented Trustee (s)ext.	Property Owners. Please list all owners of record or documented Trustee (s)
Owner/ Trustee	Property Owners. Please list all owners of record or documented Trustee (s)	Property Owners. Please list all owners of record or documented Trustee (s)	Property Owners. Please list all owners of record or documented Trustee (s)ext.	Property Owners. Please list all owners of record or documented Trustee (s)

5

Willingness to Sell: 

The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party. 

	Printed Name:	Initials	Date:
Owner/ Trustee	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.
Owner/ Trustee	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.
Owner/ Trustee	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.
Owner/ Trustee	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.	Willingness to Sell: The owner(s) of the property described on this form authorize(s) Collier County to evaluate their property for potential purchase in the Conservation Collier Land Acquisition Program. If the Board of County Commissioners authorizes staff to pursue acquisition of the property, the owner(s) is/are willing to consider a fair market value offer for the purchase or donation of the land. The owner(s) are under no obligation to accept said offer or to withhold the property from other purchase offers or development during the review period. However, the owner(s) affirm that there is no right of first refusal, option or any other contractual agreement affecting ownership pending on this property. Collier County reserves the right to withdraw this application if the owner(s) causes any material changes to the environmental significance and/or characteristics of the property or enters into any contractual agreement affecting ownership with another party.

6

All owners of record must initial this form above or submit a separate letter indicating their willingness to sell or convey. An exclusive listing agreement may be attached to this application in lieu of the owner’s signature.  If a Trustee is initialing for multiple owners, please attach a copy of the legal instrument authorizing the Trustee to convey this parcel.  Owner / Agent / Trustee signature(s) also authorizes Collier County staff, or agent thereof,  Advisory Committee members and members of the general public to enter the property upon a minimum of three (3) days notice to the property owner.  Notice shall include the day, time and approximate number of persons anticipated.

Upload Document Here Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt, .mp3, .mp4, .mov, .wmv, .avi, .flv

Contact Information for Application: 

Conservation Collier Program
3300 Santa Barbara Blvd.
Naples, FL 34116
Phone: (239) 252-2961
E-mail: ConservationCollier@CollierCountyFL.gov

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QUESTIONNAIRE AND SUPPLEMENTAL INFORMATION
To assist in the evaluation of your property, please fill out this form for EACH parcel with a unique Tax ID (folio number).

If answers to Questions only pertain to select parcel (s), please indicate in the Additional Seller Comments at the bottom of this application.

7

Folio numbers (s): 

Folio numbers (s):

8

Consideration/Payment: The property may be sold or donated to Collier County. Will the owner donate the property to Collier County?

Consideration/Payment: The property may be sold or donated to Collier County. Will the owner donate the property to Collier County?

Yes

No

I Don't Know

9

Access 

 *

Access

	Yes	No
Does the property have legal access?	Access	Access
Is the property accessible by street vehicle?	Access	Access

10

 Oil, Gas, and Mineral Rights: Does the owner hold all rights on the property?

Oil, Gas, and Mineral Rights: Does the owner hold all rights on the property?

Yes

No

I Don't Know

11

 Description and Condition of Property: Describe environment characteristics and condition of site. Also describe the type of native plant communities and degree of infestation by invasive exotic plants:

Description and Condition of Property: Describe environment characteristics and condition of site. Also describe the type of native plant communities and degree of infestation by invasive exotic plants:

12

 Land Use Activities: Describe any land clearing, excavation, agricultural, possible environmental problems and/or construction on the site. List all buildings and other structures. If cleared or harvested for timber, list last date of occurrence: 

Land Use Activities: Describe any land clearing, excavation, agricultural, possible environmental problems and/or construction on the site. List all buildings and other structures. If cleared or harvested for timber, list last date of occurrence:

13

 Toxic or Hazardous substances and Waste.  Do any of the following exist onsite:

a. Any underground tanks or toxic or hazardous substances such as asbestos, polychlorinated biphenyls (PCBs), methane gas, benzene, lead-based paint, or others?

b. Any prior use of the Property for agriculture, storage of vehicles or equipment, or commercial uses?

c. Has the Property ever been designated an environmental clean-up site?

d. Have any environmental assessments or studies (i.e. Phase I, II or III) ever been performed on the Property?

If the answer is yes to any of the above, please explain:

Toxic or Hazardous substances and Waste. Do any of the following exist onsite: a. Any underground tanks or toxic or hazardous substances such as asbestos, polychlorinated biphenyls (PCBs), methane gas, benzene, lead-based paint, or others? b. Any prior use of the Property for agriculture, storage of vehicles or equipment, or commercial uses? c. Has the Property ever been designated an environmental clean-up site? d. Have any environmental assessments or studies (i.e. Phase I, II or III) ever been performed on the Property? If the answer is yes to any of the above, please explain:

14

 Leases: Describe any outstanding leases, including farming, grazing, timber, oil, gas, mineral, etc.: 

Leases: Describe any outstanding leases, including farming, grazing, timber, oil, gas, mineral, etc.:

15

 Easements/Liens: Describe any easements or liens that exist or that have been asserted or claimed by other persons. Please describe and provide Official Records Book and Page if known.

Easements/Liens: Describe any easements or liens that exist or that have been asserted or claimed by other persons. Please describe and provide Official Records Book and Page if known.

16

 Reason(s) for Nomination: Why do you believe this property is appropriate for acquisition or preservation under Collier County’s Conservation Collier Program? 

Reason(s) for Nomination: Why do you believe this property is appropriate for acquisition or preservation under Collier County’s Conservation Collier Program?

17

 Is the sale or donation accompanied by a management endowment? Under what program and what amount is the endowment:

Is the sale or donation accompanied by a management endowment? Under what program and what amount is the endowment:

18

 Native Vegetation Requirements: Is the property being used to satisfy native preservation retention requirements for another property being developed? If so, what is the status? Please provide relevant information such as approved site development plan or other development permit evidencing approval.

Native Vegetation Requirements: Is the property being used to satisfy native preservation retention requirements for another property being developed? If so, what is the status? Please provide relevant information such as approved site development plan or other development permit evidencing approval.

19

 Transfer of Development Rights (TDR): Are the development rights proposed to be transferred or transferred using the Collier County TDR program? If so, what is the status? Please provide relevant information such as scheduled hearing date or date of Board approval. 

Transfer of Development Rights (TDR): Are the development rights proposed to be transferred or transferred using the Collier County TDR program? If so, what is the status? Please provide relevant information such as scheduled hearing date or date of Board approval.

20

 Access to Property and Rights of Others:

Access to Property and Rights of Others:

	Yes	If Yes, please describe:	No	I don't know
Is this property used by others to gain access to the adjoining property or property in the vicinity of the subject property?	Access to Property and Rights of Others:	Access to Property and Rights of Others:	Access to Property and Rights of Others:	Access to Property and Rights of Others:
Is this property used in any way by others, such as the placement of structures including fencing and drainage structures?	Access to Property and Rights of Others:	Access to Property and Rights of Others:	Access to Property and Rights of Others:	Access to Property and Rights of Others:
Is there legal and physical access to the Property by public road?	Access to Property and Rights of Others:	Access to Property and Rights of Others:	Access to Property and Rights of Others:	Access to Property and Rights of Others:
Is there legal and physical access to the Property by private road or easement?	Access to Property and Rights of Others:	Access to Property and Rights of Others:	Access to Property and Rights of Others:	Access to Property and Rights of Others:

21

 Utilities: Existing potable water supply to the Property is through:

Utilities: Existing potable water supply to the Property is through:

Public water line

Private water plant

On-site well

None

22

 Utilities (continued): Existing wastewater treatment for the Property is through: 

Utilities (continued): Existing wastewater treatment for the Property is through:

Public sewer line

Private treatment company

On-site septic system

None

23

 Utilities (continued): Existing utilities to the Property:

Utilities (continued): Existing utilities to the Property:

Electric

Telephone

Fire Hydrant

Natural Gas

None

24

 Adjacent Property: Is the owner of the property offered for sale affiliated in any way with the owner of any property adjacent /contiguous to the property being offered for consideration?  (Affiliated means by familial relationship or having corporate representatives in common)

Adjacent Property: Is the owner of the property offered for sale affiliated in any way with the owner of any property adjacent /contiguous to the property being offered for consideration? (Affiliated means by familial relationship or having corporate representatives in common)

Yes

No

25

 Adjacent Property (continued): If answer to Question 24 is Yes, what is the address and folio number of the adjacent /contiguous property? Please describe relationship to owners.

Adjacent Property (continued): If answer to Question 24 is Yes, what is the address and folio number of the adjacent /contiguous property? Please describe relationship to owners.

26

 Listing History: Has the property been listed for sale within the last five years?

Listing History: Has the property been listed for sale within the last five years?

Yes

No

27

 Listing History (continued): If the answer to Question 26 is YES, when was the property listed, and what was the asking price? If listing ended prior to application to Conservation Collier Program, why was property taken off the market?

Listing History (continued): If the answer to Question 26 is YES, when was the property listed, and what was the asking price? If listing ended prior to application to Conservation Collier Program, why was property taken off the market?

28

 As part of the acquisition process, Conservation Collier staff will conduct a site visit of the property to collect information and photographs about the plant communities present. Staff will coordinate the date and time of the site visit with the property owner or representative prior to it taking place. Do you give permission for licensed and insured staff to operate a drone on your parcel during this site visit to collect aerial photographs that aid in the assessment of the properties natural communities?

 

  

As part of the acquisition process, Conservation Collier staff will conduct a site visit of the property to collect information and photographs about the plant communities present. Staff will coordinate the date and time of the site visit with the property owner or representative prior to it taking place. Do you give permission for licensed and insured staff to operate a drone on your parcel during this site visit to collect aerial photographs that aid in the assessment of the properties natural communities?

Yes

No

29

 Please attach copies of the following information, if available.

Please attach copies of the following information, if available.

Location Map, such as a plat book page, aerial photo, or legal description Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt, .mp3, .mp4, .mov, .wmv, .avi, .flv

Wetland Survey, species survey, plant community map, or environmental report Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt, .mp3, .mp4, .mov, .wmv, .avi, .flv

Owner's title policy Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt, .mp3, .mp4, .mov, .wmv, .avi, .flv

Boundary Survey Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt, .mp3, .mp4, .mov, .wmv, .avi, .flv

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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