FS-2700-3b Special Use Application and Permit for Noncommercial Gro

Special Use Administration

fs_2700_3b

Special Use Administration

OMB: 0596-0082

Document [pdf]
Download: pdf | pdf
Auth ID: #AUTH_ID#
Contact ID: #HOLDER_ID#
Expiration Date: #EXPIRATION_DATE#

FS-2700-3b (03/06)
OMB No. 0596-0082

U.S. DEPARTMENT OF AGRICULTURE
Forest Service
SPECIAL-USE PERMIT FOR
NONCOMMERCIAL GROUP USE
(Ref.: 36 CFR 251.54)
Authority: Organic Act of 1897,16 U.S.C. 551
PART I - APPLICATION
1. APPLICANT INFORMATION:
Address of Group or Contact:
(whichever is applicable)

Name of Group or Event:

Name of Contact:
The contact shall be available to the Forest Service from the date this application is signed until it is accepted, rejected, or
denied.

Day Phone: ( )

-

Evening Phone: ( )

-

2. DESCRIPTION OF PROPOSED ACTIVITY:

3. LOCATION & DESCRIPTION OF NATIONAL FOREST SYSTEM LANDS & FACILITIES APPLICANT WOULD LIKE TO USE:

4. ESTIMATED NUMBER OF PARTICIPANTS & SPECTATORS FOR PROPOSED ACTIVITY:
Spectators:

Participants:
5. STARTING & ENDING DATE & TIME OF PROPOSED ACTIVITY:
Start

End:
Date
Time
Date
Time
6. NAME OF PERSONS WHO WILL SIGN A SPECIAL USE PERMIT ON BEHALF OF THE GROUP (May be same
as contact listed in item 1.):
Name:

Name:

Address:

Address:

Day & Evening Phone: (

)

-

/(

)

-

Day & Evening Phone: (

)

-

/(

)

-

Signature:

Signature:
Date:

Date:

APPLICATION NOT VALID UNLESS SIGNED BY CONTACT

Signature of Contact

Date

18 U.S.C. § 1001 makes it a crime for any person knowingly and willfully to make to any department or agency of the United States any false,

fictitious, or fraudulent statements or representations as to any matter within its jurisdiction. Anyone who knowingly or willfully makes or uses any
false writing shall be fined not more than $10,000 or imprisioned not more than five years, or both.



PART II – PERMIT
Purpose:
Noncommercial group use permits do not grant or deny freedom of assembly or freedom of speech. The rights to
freedom of assembly and freedom of speech are guaranteed by the United States Constitution. These rights are
fully respected by the Forest Service. When noncommercial group use permits are issued, they regulate time,
place, and manner with respect to the exercise of these rights by groups of 75 or more people on National Forest
System lands. Noncommercial group use permits authorize the holder to use and occupy the National Forest
System lands covered by the permit, subject to rights retained by the United States, including continuing rights of
access, a continuing right of physical entry for inspection, monitoring, or for any other purposes consistent with
any right or obligation of the United States, and the right to require common use of the land or to authorize use by
others in any way that is not inconsistent with the privileges granted by the permit. The use and occupancy
authorized by a noncommercial group use permit would not be allowed without the permit. The primary purposes
of noncommercial group use permits include protection of National Forest System lands and resources, promotion
of public health and safety, and allocation of space among competing uses of National Forest System lands.
1. Use under this permit shall begin on
extended.
2.

and end on

. The permit shall not be

, #HOLDER_NAME# of, #HOLDER_ADD_LINE_1#, #HOLDER_ADD_LINE_2#,
#HOLDER_CITY#, #HOLDER_STATE#, #HOLDER_ZIP# (the holder) is hereby authorized to use, subject
to the terms of this permit, National Forest System lands described as #TOWNSHIP_SECT_RANGE#
#FIRST_DIVISION# #FIRST_DIV_NAME_NUMBER#, #SECOND_DIVISION#
#SECOND_DIV_NAME_NUMBER#, #THIRD_DIVISION# #THIRD_DIV_NAME_NUMBER# as shown in
attached Exhibit(s)
#USE_MILES# miles.

. This permit covers approximately #USE_ACRES# acres and/or

3. The holder is authorized to conduct the following activities and install the following improvements in the
permitted area:
#PURPOSE#
4. The holder shall conduct the authorized activities according to the attached approved plans and specifications,
. The holder shall not install any improvements not specifically identified and
Exhibit(s)
approved in clause 3, in exhibits attached to this permit, or by the authorized officer during the activity
authorized by this permit.
5. No soil, trees, or other vegetation may be destroyed or removed from National Forest System lands without
specific prior written permission from the authorized officer.
6. The holder shall comply with all federal, state, county, and municipal laws, ordinances, and regulations which
are applicable to the area or operations covered by this permit.
7. The holder shall maintain the improvements and premises to standards of repair, orderliness, neatness,
sanitation, and safety acceptable to the authorized officer. The holder shall fully repair and bear the expense
for all damages, other than ordinary wear and tear, to National Forest System lands, roads and trails caused
by the holder's activities.
8. The holder has the responsibility of inspecting the use area and adjoining areas for dangerous trees, hanging
limbs, and other evidence of hazardous conditions which would pose a risk of injury to individuals. After
securing permission from the authorized officer, the holder shall remove such hazards.

9. The holder shall be liable for any injury, loss, or damage, including fire suppression costs and environmental
harm or injury to natural resources, that arises in connection with the use and occupancy authorized by this
permit.
10. The holder shall indemnify and hold harmless the United States for any injury, loss, or damage, including
third-party claims, damage to federal property, fire suppression costs, and environmental harm or injury to
natural resources, that arises in connection with the use and occupancy authorized by this permit.
11. The persons who sign this permit are not subject to any individual liability under this permit as a result of that
signature. They provide their name solely to allow notice of actions pertaining to the permit to be
communicated to the holder and to give the permit legal effect. At least one of the persons who sign this
permit shall be available to the Forest Service from the date this permit is issued until the use authorized by
this permit has concluded.
12. The holder agrees to permit free and unrestricted access to and upon the premises at all times for all lawful
and proper purposes not inconsistent with the intent of the permit or with the reasonable exercise and
enjoyment by the holder of the privileges thereof.
13. This permit is subject to all valid existing rights and claims outstanding in third parties.
14. This authorization may be revoked or suspended only in accordance with 36 CFR 251.60(a)(1)(i). Upon
expiration or revocation of this permit, the holder shall immediately remove all improvements except those
days, unless otherwise agreed
owned by the United States, and shall restore the site within
upon in writing. If the holder fails to remove the improvements, they shall become the property of the United
States, but that will not relieve the holder of liability for the cost of their removal and the restoration of the site.
15. This permit is a license for the use of federally owned land. It does not grant any interest in real property.
This permit is not transferable. The holder shall not enter into any agreements with third parties for
occupancy of the authorized premises and improvements.
16. Any decision concerning this permit, including but not limited to suspension or revocation and modification of
permit terms and conditions, is not subject to administrative appeal and is immediately subject to judicial
review.
17. This permit is accepted subject to the conditions set forth herein, including any conditions in any exhibits
attached to and made a part of this permit.
18. The above clauses shall control if they conflict with additional clauses or provisions.
#INSERT TERM HERE#

I have read and understand the terms
and conditions and agree to abide by them.
HOLDER:
By:

U.S. DEPARTMENT OF AGRICULTURE
Forest Service
Authorization is granted:
By:

Name:

Name:

Date:

Title:

Date:

HOLDER MUST HAVE THIS PERMIT (OR A LEGIBLE COPY) IN POSSESSION DURING THE AUTHORIZED
ACTIVITY
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a
collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 05960082. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin,
gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.)
Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should
contact USDA’s TARGET Center at 202-720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 202509410 or call (800) 975-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.
The Privacy Act of 1974 (5 U.S.C. 552a) and the Freedom of Information Act (5 U.S.C. 552) govern the confidentiality to be provided for information
received by the Forest Service.


File Typeapplication/pdf
File TitleAuth ID: #AUTH_ID#
AuthorFSDefaultUser
File Modified2006-09-27
File Created2006-09-27

© 2024 OMB.report | Privacy Policy