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["（別紙３　様式第12号）"]
["番　　　号"]
["年　月　日"]
[]
["○○地域協議会"]
["会長　○○　○○　殿"]
["                                                             ○○活動組織　　　　　"]
["代表　○○　○○　　"]
[]
[]
["○年度　森林・山村多面的機能発揮対策交付金に係る採択申請書"]
[]
["　森林・山村多面的機能発揮対策実施要領（平成25年５月16日25林整森第74号林野庁長官通知）別紙３の第５の４（１）に基づき、下記のとおり森林・山村多面的機能発揮対策交付金の採択を申請する。"]
[]
["記"]
[]
["１．活動組織名"]
[]
[]
["２．協定の対象となる森林の位置"]
[]
[]
["３．担当者名・電話番号（連絡がとれる担当者及び電話番号を記載）"]
[]
[]
[]
["４．森林・山村多面的機能発揮対策交付金"]
[]
["取組メニュー",null,null,null,"交付単価等",null,"森林面積等",null,"交付金額",null,"都道府県の    支援額",null,"市町村の      支援額",null,"計"]
["活動推進費",null,null,null,"112,500円",null,"初年度のみ",null,"円",null,"円",null,"円",null,"円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(I31:N31)","v":0}]
["地域環境保全タイプ（里山林保全）",null,null,null,null,null,"ha",null,"円",null,"円",null,"円",null,"円"]
[null,null,null,null,"120,000円/ha",null,null,null,{"$f":"G33*120000","v":0},null,null,null,null,null,{"$f":"I33+K33+M33","v":0}]
[null,null,null,null,"115,000円/ha",null,null,null,{"$f":"G34*115000","v":0},null,null,null,null,null,{"$f":"I34+K34+M34","v":0}]
[null,null,null,null,"110,000円/ha",null,null,null,{"$f":"G35*110000","v":0},null,null,null,null,null,{"$f":"I35+K35+M35","v":0}]
["地域環境保全タイプ（侵入竹除去・竹林整備）",null,null,null,null,null,null,null,"円",null,"円",null,"円",null,"円"]
[null,null,null,null,"285,000円/ha",null,null,null,{"$f":"G37*285000","v":0},null,null,null,null,null,{"$f":"I37+K37+M37","v":0}]
[null,null,null,null,"265,000円/ha",null,null,null,{"$f":"G38*265000","v":0},null,null,null,null,null,{"$f":"I38+K38+M38","v":0}]
[null,null,null,null,"245,000円/ha",null,null,null,{"$f":"G39*245000","v":0},null,null,null,null,null,{"$f":"I39+K39+M39","v":0}]
["森林資源利用タイプ",null,null,null,null,null,"ha",null,"円",null,"円",null,"円",null,"円"]
[null,null,null,null,"120,000円/ha",null,null,null,{"$f":"G41*120000","v":0},null,null,null,null,null,{"$f":"I41+K41+M41","v":0}]
[null,null,null,null,"115,000円/ha",null,null,null,{"$f":"G42*115000","v":0},null,null,null,null,null,{"$f":"I42+K42+M42","v":0}]
[null,null,null,null,"110,000円/ha",null,null,null,{"$f":"G43*110000","v":0},null,null,null,null,null,{"$f":"I43+K43+M43","v":0}]
["森林機能強化タイプ",null,null,null,"800円/ｍ",null,"ｍ",null,"円",null,"円",null,"円",null,"円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(I45:N46)","v":0}]
[]
["関係人口創出・維持タイプ",null,null,null,"50,000円",null,null,null,"円",null,"円",null,"円",null,"円"]
[null,null,null,null,"/年",null,null,null,null,null,null,null,null,null,{"$f":"SUM(I48:N48)","v":0}]
["小　計",null,null,null,null,null,null,null,"円",null,"円",null,"円",null,"円"]
[null,null,null,null,null,null,null,null,{"$f":"I31+I34+I38+I42+I45+I48","v":0},null,{"$f":"K31+K34+K38+K42+K45+K48","v":0},null,{"$f":"M31+M34+M38+M42+M45+M48","v":0},null,{"$f":"O31+O34+O38+O42+O45+O48","v":0}]
["資機材・施設の整備等",null,null,null,"1/2 以内",null,"円",null,"円",null,"円",null,"円",null,"円"]
[]
["資機材・施設の整備等（林内作業車、薪割り機、薪ストーブ又は炭焼き小屋等）",null,null,null,"1/3 以内",null,"円",null,"円",null,"円",null,"円",null,"円"]
[]
[]
[]
["計",null,null,null,null,null,null,null,"円",null,"円",null,"円",null,"円"]
[null,null,null,null,null,null,null,null,{"$f":"I50+I52+I54","v":0},null,{"$f":"K50+K52+K54","v":0},null,{"$f":"M50+M52+M54","v":0},null,{"$f":"O50+O52+O54","v":0}]
["間伐等（除伐、枝打ちを含む。）の実施面積",null,null,null,null,null,"ha"]
[]
["当該年度に長期にわたり手入れをしていなかったと考えられる里山林を整備する面積",null,null,null,null,null,"ha"]
[]
[]
[]
["（注１）面積は0.1ha、延長はm単位で記入。"]
["（注２）当該年度に長期にわたり手入れをしなかったと考えられる里山林を整備する面積は、活動期間内の前年度までに該当する里山林の整備を実施した場合は、その森林の面積を除外し、当該年度に新たに里山林の整備を実施する面積を記載すること。"]
["（注３）都道府県の支援額、市町村の支援額及び計については、申請時に都道府県や市町村から予定額を聞いている場合等に記載すること。"]
["（注４）地域環境保全タイプ及び森林資源利用タイプの交付単価は、活動計画の経過年度によって異なるので留意すること。"]
[]
["５．事業費（活動推進費＋各タイプ計＋資機材・施設の整備（購入額））"]
[]
[]
["６．月別スケジュール"]
["取組内容",null,null,null,"４月","５月","６月","７月","８月","９月","10月","11月","12月","１月","２月","３月"]
["１．活動推進費"]
["２．実践活動"]
["　A-1 地域環境保全タイプ（里山林保全）"]
["　A-2 地域環境保全タイプ（侵入竹除去、竹林整備）"]
["　B 森林資源利用タイプ"]
["　C 森林機能強化タイプ"]
["　D 関係人口創出・維持タイプ"]
["３．資機材・施設の整備等"]
[]
["７．安全講習等の名称及び内容"]
["講習の名称",null,null,null,"講習の内容",null,null,null,null,null,null,null,null,"実施月"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"月"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"月"]
[]
[]
["８．関係人口創出・維持タイプの相手先及び活動内容"]
["【地域外関係者の相手先名】 "]
["【活動内容】 \n"]
["（注）地域外関係者との現地確認や活動内容の調整を必ず行うこと。"]
[]
[]
["＜施行注意＞"]
["  作業安全のための規範（個別規範：林業）事業者向けチェックシート、環境負荷低減のクロスコンプライアンスチェックシート、活動計画書、協定及び活動組織の運営に関する規約等を添付するものとする。\n　記載事項及び添付資料が既に提出している資料の内容と重複する場合には、その重複する部分については省略できることとし、省略するにあたっては、提出済の資料の名称その他資料の特定に必要な情報を記載の上、当該資料と同じ旨を記載することとする。"]