Form BLM_4130-3a Automated Grazing Application

AUTH NUMBER: 2501219
DATE PRINTED: 3/112007
SblIndord
TDrm. 2nd Condltlon&
1.

C:l"';u;nQ p~,.m;t

1<:l.:J::C:tcrm:;. ;,nd l;ond, tion::;
.:1nd 'the 'Fc:~~ c:h.3ra~d ·For
of the 1~:Jr.::l.='n~,.e9ul.;:).t'ion~ now or h~rt::aft:c'"
;,pprOvl::d

;'\1' tl-u: prov,~;on::;
2.

ar~::~nl:lUH~~~re.

or

by the s~r.:r~t!lry

They ::Ire :::ub';c:ct
to <:~nccl':3t.;on,
in whol t: or in ~3.rt,
~t A"'~ tiMe bec:t\uH
of:
:J. Noncompl., ",nee by trc: perm; ttc:cJlc:;:;.cc
witn
I"'ul
l\nd r~lJu' lI..t"tOMS.
b. Lo::;:; of COr'ltrol
by tn(: pc:rmit.tcl:/'~~~~e
of &11 or Q. t'~rt
of the
prOf')l'!l"ty I.Iptl" vlIh1ch 1r. 1,(, b",;:ad.
<:. A tr~n,f~r
of ·~r~:'inQ pr~rer~nc:e
by 'the perll,,,Il::.tei!/'~:99~~to "n!'>th!!r f')~rty.
d. A dc:crc:a.5c
it'l th~ 1.:snd3 ~dmin':st~re.d
by th~ 13ure~u
L/,l,ncl MQl'\ta.gel\1l'!nt w1th1'l
r,he ;'1"(')tmQnt.<~)
dntcr1bnd.
c. ~eD~!lted ",;,,;'\.11
un!UthOr;l~d ar8.~~no u:!e,

t,

o'r

7,

G-r~7.1ng

$epr,~l'IIbc:p·

pCH·,rdT,~ or
(4,

J,t.i5d,

~
1.1•••.
C1~tock
!Jr.:1J:1ng pQriod

::'l~

gr,J:;o:ing
~nd

lA'l~Q:': ;,rQ
:'lInClndC",d.

.'l:UbjRCt: to th~ nond;,;cr;J'1'l;n,J'tlon
<:lau:;c,;:
coey
of th;::
order
I\'1;)Y be obt.ainc:d
froltl

A.

th.::l't l.'l: diffr,!""o::nt
bQ fil'ld
with
:lnd

\J~~

,I.foJS.T

from

that

J.uthorized
by :::I perIMit
.:luth\Jri=~d
office:r

.:J:ppre-vC!d by th~

!) Rnl"ing
not;cQS:
:\rQ ir,.'l:u"ld which
,c:pRc;f)l
fr.~::: due.
a'i"":;n~
'~.;):~c. GrJzing
USI: CJMnot bl: :1u'thtlri=ed
curin9
Qny period
of
~J'lttl€l""C'lnt
for
un;,uthori;O:C1d
us::~.
10, GrA;zinlJ
th{! due dflte,
rriu,,~.
~ 1"te

f~'1,

p~YIn~nt!=

l!XC;f!Pt

f~~

qh(l

~~

:;c:::t -For'"tn in EXl:l:IJti"c
Ordc:::r- 11216
the
:s.uthl;)l"iz:c:d I;),Ffir::el"',

noticc:::,
\Ilhen
dl:linClUtnc:y
in

or

l~a~~

bc'Fore
t:l3~d,

IJlUS'T b~
Qr~r"inQ

become

I!ppl'i-ed for
pr'ior
U~e: c:an be ma.de,

3 P30rt of
aJ'!lount~

'c!'l~ t:ls.yrn~nt or

of

tne

~r~~'inQ

ttl@

to

t:l~rm';'t or

1nc1wd';no

duel

':-i~ rfu~ on thl! 11At,~ sPQcifiC)r:!
on r,hCl bi11ing
notice:
:md MUST bE: p:lid
in full
within
15 c'l1Y~ of
prClv1d~rt
in r.h~ gr;;q'iniJ
p",rm1t
Qr
lA:lt::~. If p:\)lm~nt.
is net: made wl'thin
th;'Lt. time:
(If $<5 ('Jr ,to p~"'Arrr ()f thQ ::'IrtJOUr'lt OlVan but riot morro: th.:ln ~2S0) will
be: :l~~C'Bc:d.

oth~1""W1!=1!
Ijr@~t,!r

,') .. l'olo M"'Mb'"r of,
0 r Da 1 ~g~tCl to.
Con grAH
0" rtQ.'t1 dCH'lt Co""m; :r.1 oncr.
:\ ftc::r hi:: e:1~c:ti on of J"PO i ntmcnt
or c;: thcr
be fore::
o r ~ ftQ r ~~ h.:u: q u;'!11 f1 d, .::lnd du ri n9 hi j; co nti nU.J.ncc
; n off;
CI:.
ond no offi ce: 1"', ::l,~c:nt. 0 r e:IIlP1oyec: of tne: Dl:pe rtMlen c of
r,~(l. !.ntClr1or,
othll.r
th~n I'llQ",bRr~ of Ad"hory
cC'mm;tter.:::
;-.ppointcd
in :lccord.1nc:c:
with
the:: Federal
Advl~Qrv
Cornmittc::c
ACt
($ U.S.c. App.L) ,nd Sr.ct~on< )09 of tn. Fc~r."l
L"nd Policy "nd ""n"90mcnt Act of 1976 (13 u.s.c.
1701 .t "Q.) 9h.11
bl'1 .,d!llittcd
to Jny r,h:lrt", or p:1rt: in ~ pcrm~t
or le~:;:c, or dl::r~ve
any benefit
to ar'; ~~ ch'!!r~from:
snd the prov~91cn
of'
~~ct.1Dn 3104:1.R.ll.vi(~d St~r.ut~t:: (41 U_~_C
~,,: le: u.!'..c.
S~ctiom:
4..~1-.03,
.1nd 4.:1 c~~ P~rt 7),
ent.er
into llr'ld r-orm a pan:
of;,
gr::'l:x'in9 plllrmit or 1R-=!!i:", ~o f:t.r :n: r.hQ ~':lIU m"y br. :\pplic:Jb10.
1

Q

Title
18 I).S.C..
S~~tior'l 1001 m8kl:' it 3. crlme: 'for ~ny per50"
kno\Y';"ctly and w-:11ful1y to m~k~ to ~ny dep~rtM~nt
~', I,~, liI:'I;ci\1ngtnn
D.'::.
,0:(40,

Dj)p~rtmQnt

of

N.W.,

S'top

M:dl

!3l!r~~IJ cl~"r"n<:1!

off1~.t!'r

(WC-630).

C~OO"-OlM:t).

TH~S IS NOT A BILL

1649

C

~t.

per

AUTH NUMBER: 2501219
DATE PRINTED: 3/112007

FORM APPROVED
OMS NO. 1004-0041
Exp)res: March 31, 2008

Form 4130-3a
CAp r-i
1 2002)
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT

STATE
OFFICE
AlJTH NUMBER
PREFERENCE CODE
DATE PRINTED

GRAZING APPLICATION
IF CHANGED

RETURN BY MARCH 10, 2007

MT

030
2501219

15
03/01/2007

BUREAU OF LAND MANAGEMENT
NORTH DAKOiA FO
310 ROUNDUP ST
BELLE FOURCHE SO 57717

EXAMPLE PEMITTEE/LESSEE
PO BOX 25047
DENVER CO 80225-0047

INSTRUCTIONS: DO NOT RETURN THIS FORM UNLESS YOU ARE REQUESTING CHANGES.
Th)s application restates terms
and conditions from your SlM grazing lease. Grazing bills w)11 be based on these schedules unless you
request changes which are subsequently approved by the BLM. To request chanqes: edit the schedules and
then sign and return the form by the date shown above. A service charge wil be assessed for changes
which require a reissue of a grazing bill. Contact your local BlM office at 605-B92-7000 )f yOU have
questions.
MANDATORY

TERMS AND CONDITIONS

ALLOTMENT
SCHEDULE NUMa~
03133 WAGON BOX
0313 3 WAGON BOX
03133 WAGON BOX

ALLQIMENLSllMMABY
ALLOTMENT

TJoiREE

ONE
TWO

LIVESTOCK
~6..E.B. lWJ.Q.

GRAZING
a..E.(ill;l

225 CATTL.E
225 CATTLE
225 CATTLE

05/01/07
06/24/07
08/17/07

f.E.B.I.Q2
.Elli>.
06/23/07
08/16/07
10131/07

(AUMS)
ACTIyE AWMS-.
1000

TH is

is NOT

A 8~LL

~

TYPE USE
70 ACTIVE
60 ACTIVE
86 ACTIVE