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2. Wahkiakum County Weed Board & Road Department

   Application and Release for Controlling Noxious Weed and Brush on County Right-of-Way

4. Name:*
5. Phone Number:*
7. Mailing Address:*
8. Email Address:
10. Property Address:*

12. The undersigned applicant acknowledges and agrees to the following:

    1.  Wahkiakum County uses various approved herbicides for weed control along county right-of-ways.  If the applicant requests that the County not spray the right of way adjacent to the applicant's property, then it becomes the applicant's responsibility to maintain vegetation control along said right of way.

    2.  Applicant requests that Wahkiakum County not spray at the above-specified location.  Wahkiakum County shall provide and install signal signs indicating that the right of way is not to be sprayed.  Failure to maintain signs will void this agreement.

    3.  Applicant shall maintain the right of way according to county standards, refer to the Statement of County Standards.  If the applicant fails to maintain the right of way, the County will send to the applicant at the above-listed mailing address a certified letter detailing the areas of concern.  The applicant will have twenty (20) days from the date the letter was mailed to perform the work or county personnel may perform the necessary work.

    4.  Under any agreements for vegetation management, the County will reserve the right to remove dangerous trees or other vegetation that presents a safety issue.

    5.  It is understood and agreed that the clearing of shrubs, brush, and limbs and all necessary maintenance needed shall be performed by the applicant at no cost to Wahkiakum County.  All debris shall be cleaned up to the satisfaction of the County.

    6.  If satisfactory vegetation control by the property owner is not implemented, the County will resume spraying or other means of vegetation management to restore proper control.

    7.  Applicant agrees to assume all risks attendant to control of vegetation along said right of way and to defend and hold harmless Wahkiakum County and its elected officials and employees from any and all claims, costs, and damage which may arise as a result of applicant's vegetation.

    8.  This application shall be void and of not force and effect upon the occurrence of any of the following events: (i) if the applicant fails to maintain right of way as described in paragraph 3; (ii) if the applicant sells, leases, transfers, or otherwise relinquishes control of the property, or (iii) if applicant sends via certified mail written notice of cancellation to the Wahliakum County Road Department, PO Box 97, Cathlamet, WA  98612, whereupon this application shall be deemed voice (20) days from date of mailing.

    I agree to the above conditions.

14. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
16. Electronic Signature
17. Date:
Leave This Blank:


19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit

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