Environmental Services is conducting surveys on properties along Johnson Creek and the Columbia Slough to count native ash trees. If you received a letter in the mail from us requesting permission to enter your property to conduct this survey, please complete the form below.

Please contact Dominic Maze at dominic.maze@portlandoregon.gov or 503-823-5988 for more information or questions regarding this study.

* Required Field

Emerald Ash Borer Survey Participation Agreement

Property address:*

e.g. 1120 SW 5TH or 5TH AND MAIN

PERMISSION TO ENTER

By granting permission, you are allowing Environmental Services staff and/or our ecological consultant to access the property at the address above to conduct a survey of the property within 100 feet of the stream. The survey will determine whether there are ash trees on your property, how many, and the health of the trees. Surveys will be conducted before October 31, 2020 and will take place during normal business hours, Monday through Friday. You do not need to be at home during this visit.

Check one:*

Check one: I grant permission to access my property. I grant permission to access my property under the conditions listed below. I do not grant permission.

If you granted permission with conditions, please describe the conditions:

Type your name here to sign this agreement:*

Date:

Phone number:*

Email address:

Mailing address (if different from property address above):

The City of Portland, Oregon

Environmental Services

working for clean rivers

Emerald Ash Borer Survey Participation Agreement