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Defensible Space Assistance Form

  1. This is my primary residence:
  2. I am the owner of this property:
  3. This form must be approved by the owner before work can be performed.
  4. I understand that:
  5. This is a one-time assistance program to create defensible space and wildfire education. The program is not for removal of trash or trees over 8" in diameter. Completing this application does not guarantee that you will be assisted; applicants will be prioritized with the following criteria:
  6. 1. Financial Ability
  7. 2. Severity
  8. 3. Location
  9. Priority is based on the address's radius to potential wildfire impact which considers vulnerability, emergency road access, utilities and topography. This also accounts for legal limitations, living in the eligibility zone, and proximity to other priority project sites.
  10. 4. Fire Marshal's Assessment of Impact
  11. Electronic Signature
    I certify by signing below, this is true and correct: I understand that defensible space created by the WUI Collaborative and their contractors does not guarantee that my home will not be lost in the event of a wildfire. I understand that ongoing maintenance is a critical component of wildfire resiliency past the one-time service this project provides. This service is provided on numerically generated data that determines the order of priority. I agree to provide access to water, bathroom facilities, and use of any onsite tools to complete the necessary work in cooperation with the NYC crews. I certify that the above information regarding income is true and correct and I understand that the information provided is subject to verification in qualifying to receive service.
  12. Electronic Signature*
    By checking this box, I am providing an electronic signature.
  13. Leave This Blank:

  14. This field is not part of the form submission.