PERMFILE69717

• Permit No: M1995063
• IBM Index Class Name: Permit File
• Doc Name: AFFIDAVIT
• Media Type: D
• Archive: No

U.S. DEPARTMENT OF APICULTURE O CO-S;CS-5
SOIL CONSERVATION SERVICE (180•-12-11)
COLOIRADO Rev,. 4/92
PART II - GRASS SEEDING APPLIED
Seedbed Preparation: Method Date
Dead Litter Cover: Kind, Pounds residue present
Clean ti'_1, Firm Seedbed, Interseed, Other
Seeding Operation: Drill Int:erseed Broadcast Date
Drill spacing Type Planting depth
Fertilizer: Pounds actual available nutrient per acre applied.
Nitrogen (N2) Phosphorus (P205) __ Potassium (IC)
Weed Control: Chemical, Kind fi Amount Mechanic<sl
Flash Grazing __ Dates
Mulch: Kind Amount__ lbs/Ac. How applied
How anchored Anchored depth _
Seed Purchased & Applied:
(6) (~) (a) (9)
lbs bulk $ germi- $ $ PIS
Species Variety seed nation Purity (7)x(8)
(10) (11) (12) (13) (14) (15) (16)
Tota]. lbs Acres PLS lbs $ Species Cost bulk Cost/PLS PIS
PIS appl'd seeded Appl'd/Ac. seeded seed lb appl'd cost/ac
(6)x(9) (10)=(11) (12)=(1) applied (14)=(10) !15)x(12)
Total t of species seeded
Total Seed cost/Ac.
Maximum alloyed for payment when Total in column (13) exceeds 125$.
Total. col. (16) x 1.25 = total ail. (13) x col. (il) = allowable cost
share of $ Co 1. (16) = (13) _ $ average cost/Ac.
Show method of measurement.
Attach actual cost information, ;seed tags, other calculations and any
pertinent information. Seedings of less than 90$ of specifications will
need state office approval.
I CERTIFY THAT TH:~ ABOVE PRACTICE MEETS SPECZFICAT]:ONS
Date checked and certified: Signed