HomeMy WebLinkAboutCalifornia Department of Forestry and Fire Protection (CAL FIRE) 2026-03-12STATE OF CALIFORNIA, NATURAL RESOURCES AGENCY
DEPARTMENT OF FORESTRY AND FIRE PROTECTION
COOPERATIVE AGREEMENT/LICENSE
for Prevention and Suppression of Forest Fires
CAL FIRE 719 (REV. 1/26) (Page 1 of 5)
CAL FIRE #
(No. assigned by HQ TS, Right of Way Unit)
COOPERATIVE AGREEMENT/LICENSE
PROJECT
NAME:
UNIT
Designated LICENSOR:
(Owner as
Recorded)
Designated
LICENSEE:
Supervising Right of Way
Agent
AUTHORITY
CITED:
Public Resources Code 4141. The Department may, for the prevention and
suppression of forest fires, enter into cooperative agreements with any person,
firm, association, or corporation that owns or controls any forest, brush, grass,
or grain lands, under such terms as the Department deems advisable, and may
renew, revise, or terminate these agreements.
Government Code 14662.5. In any agreement entered into whereby the state
obtains a grant of easement, lease, license, right-of-way entry (including without
limitation, a right-of-way, or right of entry on or over property of any railroad), the
state agency or its director entering into the agreement on behalf of the state
may agree to indemnify and hold harmless the grantor, lessor, or licensor and
may agree to repair or pay for any damage proximately caused by reason of the
uses authorized by such easement, lease, license, right-of-way, or right of entry
agreement.
THIS AGREEMENT DATED: ___________________________
This agreement will remain in effect for a period of up to ten (10) years or until LICENSOR or
LICENSEE terminate the agreement or property changes ownership and thereby shall be renewed).
By and between LICENSOR and LICENSEE, named above, in consideration of public services to
be performed by LICENSEE for the prevention and suppression of forest fires, hereby licenses to
the LICENSEE, use of the property under the ownership and/or control o f LICENSOR, described
as follows:
PROPERTY
DESCRIPTION:
Provide address, Assessor Parcel Number (APN) and/or portion of
Section/Township/ Range, and/or other parcel identifier(s): (attach table
identifying landowner(s) and associated APN’s or identifying legal
description.)
3/12/2026
STATE OF CALIFORNIA, NATURAL RESOURCES AGENCY
DEPARTMENT OF FORESTRY AND FIRE PROTECTION
COOPERATIVE AGREEMENT/LICENSE
for Prevention and Suppression of Forest Fires
CAL FIRE 719 (REV. 1/26) (Page 2 of 5)
CAL FIRE #
(No. assigned by HQ TS, Right of Way Unit)
PURPOSE: Said Agreement on the above described premises will be as follows:
☐Right of entry for field work related to the development of Fuels
Reduction Projects.
(No California Environmental Quality Act (CEQA) documentation
required, no ground disturbing activities required)
☐Implementation of work per approved CEQA documentation. (Non-fire
specific)
CEQA State Clearing House Identification Number required.
SCH ID #: _______________________
☐Other: __________________________
Purpose Description:
ATTACHMENTS:
SUBJECT TO:
RIGHT TO
TERMINATE:
Total number of pages attached _________, if applicable - include the
following checked items:
☐Legal description ☐Location map
☐Site plan ☐Assessors map (with project boundaries)
☐Other: ______________________
To the extent that they can legally do so, both parties to this agreement agree
to hold each other harmless against any and all claims for injury to the person
or damage to the property, arising from the uses herein stated, except where
such injury or damage is proximately caused by the negligent or willful acts of
any persons not acting under or on behalf of either party to this agreement,
its servants, agents, or employees. This form must be routed to Sacramento
Right of Way Unit if exchange of resources for the project is required.
Either party may terminate this Agreement with 90 days written notice, and in
event of and prior to such termination, reserves the right to remove any
improvement erected by it upon the said premises.
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4
2
4
STATE OF CALIFORNIA, NATURAL RESOURCES AGENCY
DEPARTMENT OF FORESTRY AND FIRE PROTECTION
COOPERATIVE AGREEMENT/LICENSE
for Prevention and Suppression of Forest Fires
CAL FIRE 719 (REV. 1/26) (Page 3 of 5)
CAL FIRE #
(No. assigned by HQ TS, Right of Way Unit)
LICENSOR LICENSEE:
or authorized Agent for landowner:
Print Name:___________________________
Signature:____________________________
Owner ☐ Agent ☐ (Controls Property)
*Signature:__________________________
Date: ______________________________
Email: _____________________________
*Note: Under penalty of perjury Authorized
agent signature acknowledges owner consent.
State of CA Department of Forestry and Fire
Protection Unit Chief or Vegetation
Management Plan (VMP) coordinator
Signature:______________________________
Date: _________________________________
Email: _________________________________
**Technical Services Supervising Right of Way
Agent
Signature:______________________________
Date:__________________________________
**Signature required if funds are exchanged for
the project.
Sage Sangiacomo
4
ssangiacomo@cityofukiah.com
03/30/2026
STATE OF CALIFORNIA, NATURAL RESOURCES AGENCY
DEPARTMENT OF FORESTRY AND FIRE PROTECTION
COOPERATIVE AGREEMENT/LICENSE
for Prevention and Suppression of Forest Fires
CAL FIRE 719 (REV. 1/26) (Page 4 of 5)
CAL FIRE #
(No. assigned by HQ TS, Right of Way Unit)
COOPERATIVE AGREEMENT/LICENSE (CAL FIRE 719) INSTRUCTIONS
CAL FIRE has its own statutory authority to enter into agreements with property owners for the
prevention and suppression of forest fires, including, but not limited to: fire access truck trails, fuel
breaks, weather telemetry stations, surveys for CEQA, access roads, utilities, water facilities,
training sites, fire control staging areas, communications, etc.
Unit to fill in the form according to the following instructions:
Maintain CAL FIRE-719 form file at the Unit level when there is no exchange of funds and the 719 is
used for access for the prevention and suppression of forest fires. This includes but is not limited to:
maintenance of fire access truck trails, fuel breaks, weather telemetry stations, surveys for CEQA,
access roads, utilities, water facilities, training sites, fire control staging areas, and communications
sites.
Provide CEQA documentation (if applicable) when requesting a CAL FIRE NUMBER. The use of this
form is not for beneficial fire agreements. A RM-70, RM-75, or RM-80 is to be used for beneficial fire
agreements.
If the project does have an exchange of funds for the landowner, then submit a completed CAL
FIRE-719, project map outlining affected APN(s) for each affected ownership, and attached
documents via email, to the Right of Way Unit, Sacramento Headquarters, Technical Services –
rightofwayunit@fire.ca.gov for review prior to gaining property owner signature. Once landowner(s)
and attached documentation are verified, the CAL FIRE-719 will be returned with an assigned CAL
FIRE NUMBER, and Supervising Right of Way Agent approval.
1.Once approved and returned to you via email or through DocuSign signature application
the submitter will acquire landowner(s) signature via DocuSign or “wet ink”.
2.Have all originals signed and dated by an appropriate CAL FIRE person responsible for the
agreement (Unit Chief or VMP coordinator), in the LICENSEE section BEFORE sending out
to “LICENSOR” for signature.
3.Return the DocuSign form through email or completed originals with wet signatures to
the Right of Way Unit, Sacramento Headquarters, Technical Services, Right of Way Unit
-PO BOX 944246, Sacramento, CA 94244-2460 or if using overnight mail, 1131 S
Street, Sacramento, CA 95811.
4.When received by Sacramento Headquarters, Technical Services, Right of Way Unit, the
Supervising Right of Way Agent will sign and date, as the Licensee for the State of
California. (DocuSign or applicable signature application is an allowable signature)
If wet ink signatures are used:
•Executed originals will be returned to the Unit for distribution. Maintain one for
the Unit and one for the Landowner, “Licensor”.
•One (1) fully executed agreement will be retained by Sacramento Headquarters,
Technical Services, Right of Way Unit.
5.If payment is involved, Sacramento Headquarters, Technical Services, Right of Way Unit,
will notify accounting to schedule payment(s).
STATE OF CALIFORNIA, NATURAL RESOURCES AGENCY
DEPARTMENT OF FORESTRY AND FIRE PROTECTION
COOPERATIVE AGREEMENT/LICENSE
for Prevention and Suppression of Forest Fires
CAL FIRE 719 (REV. 1/26) (Page 5 of 5)
CAL FIRE #
(No. assigned by HQ TS, Right of Way Unit)
FIELDS TO BE FILLED:
CAL FIRE NUMBER: Provided by Sacramento Headquarters, Technical Services, Right of
Way Unit when an exchange of funds occurs with the landowne r.
PROJECT: Provide Project Name. (Location, Purpose, i.e. Redding AAB, Air Attack
Management Class).
UNIT: Provide Project Unit location.
LICENSOR: Provide Name of Property Owner or landowner representative.
LICENSEE: This is the Right of Way agent in Technical Services, only complete if Funds are
exchanged for the agreement.
THIS AGREEMENT: Enter date Agreement is to begin. (Allow 1-2 weeks for review and approval).
PROPERTY DESCRIPTION: Provide Address, APN, and/or portion of Section/Township/Range,
and/or any other identifier(s).
PURPOSE: Provide specific details of what property is to be used for.
ATTACHMENTS IF NEEDED: If applicable, enter the number of pages of attachments to be
submitted. Double click on box that applies if including an attachment. Under “default value” choose
“checked”. When checking “other”, please provide brief description (i.e. Fee and Schedule, additional
detail, etc.).
156 19 0 0 1
0 0 1 0 3 0 0 1
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15625 0 0 1
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1 85 0 1 025
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1 8 4 0 33 0 11 8 4 0 33 2 0
253
20
Ukiah
MAP EXTENT
O VERVIEW
Ukiah West Hills VTP
Vegetation Management Program - Parcel & Responsibility Map 8
3/10/2026 LWJ
Project Impact Zone
Parcel Layer
Responsibility
Calfire_Responsibility
City Responsibility
Sections 6, 7 & 8; T21N; R11W; Sections 1-6 & 10-14; T21N; R12W; Sections 1; T21N; R13W; Sections
31; T22N; R11W; Sections 25, 27-30 & 31-36; T22N; R12W; Sections 25 & 36; T22N; R13W; MDB&M
USGS 7.5' Quads: Dos Rios, Jamison Ridge & Thatcher Ridge
0 10.5
Miles
Scale: 1:40,000