HomeMy WebLinkAboutLandowner Agreement FormOctober 17, 2019
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Town of Ithaca
Landowner Agreement
Deer Management Program
The landowner(s) hereby grants permission to the Town of Ithaca, its employees and representatives, and
the hunter / harvesters (Participants) participating in the Town of Ithaca Deer Management Program to
enter upon my/our property located at _________________________________, Ithaca NY, 14850, Tax
Parcel No(s) __________________________________________ for the following purpose(s) /
activity(ies) [initial each line for which permission is granted]:
1. ______ to shoot deer using:
a. ______ vertical bow
b. ______ crossbow
c. ______ shotgun/rifle
2. ______ to place and maintain bait station(s).
3. ______ to place and maintain tree stand(s).
4. ______ to discharge a vertical bow within 150 feet of any structure on my Property.
5. ______ to discharge a crossbow within 250 feet of any structure on my Property.
6. ______ to discharge a firearm within 500 feet of any structure on my Property.
7. ______ to track and retrieve a deer on my property.
8. ______ to field dress a deer on my property.
Special Conditions / Limitations on the permission granted: ____________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____ Yes ____ No I would like the opportunity to keep one or more of the deer harvested from my
property if they become available. I understand that I will be responsible for all costs associated with
processing.
I understand that other than the possible allocation of harvested deer to me, I have been promised no
payment or compensation of any kind, and that my participation in the program as a landowner is strictly
voluntary.
October 17, 2019
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This agreement stays in effect from the date it is signed, but can be terminated or changed at any time by
the landowner by notifying the Town of Ithaca Town Clerk at townclerk@town.ithaca.ny.us or 215 North
Tioga Street, Ithaca NY 14850.
Landowners will be notified annually prior to the start of a new program season and each year throughout
each active program season.
Landowner’s Contact Information:
Mailing Address:_________________________________________________________________
Email(s): _________________________________________________________________
Phone(s): _________________________________________________________________
Landowner’s signature: ___________________________________ Date: ______________
Print Name: ___________________________________
Landowner’s signature: ___________________________________ Date: ______________
Print Name: ___________________________________
Please return completed form to:
Michael Smith, Senior Planner
Town of Ithaca
215 North Tioga Street
Ithaca, NY 14850