Firewise Evaluation Permission Form Date * MM DD YYYY Name * First Name Last Name Lot Number * Property Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Mailing Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Alternate Phone * (###) ### #### Email * I agree... By checking "YES", I agree to have my property in Chaparral Pines evaluated, in conjunction with the Chaparral Pines Community Wildfire Firewise Protection Plan. I understand that properties that are evaluated and deemed to meet firewise standards will remain listed as firewised for 3 years. To maintain firewise status, the property must be reevaluated again in 3 years. By signing this form I give permission for the person(s) conducting the evaluation to enter upon my property for the sole purpose of conducting the Wildland Fire evaluation. This does not give the Association permission to cut or remove any vegetation from my property. * YES NO Do you wish to be present? * Yes No Thank you!
