FS-2700-4i Special Use Permit for Outfitting and Guiding

Special Use Administration

FS_2700_4i

Special Use Administration

OMB: 0596-0082

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Use Code: 153
Issue Date: #ISSUE_DATE#
Authorization ID: #AUTH_ID#
Expiration Date: #EXPIRATION_DATE#
Contact ID: #HOLDER_ID#

FS-2700-4i (03/06)
OMB No. 0596-0082

TIN number:

SPECIAL USE PERMIT FOR
OUTFITTING AND GUIDING
Authority: Federal Lands Recreation Enhancement Act, 16 U.S.C. 6802(h)
(Ref. FSM 2709.11, section 53.1)

#HOLDER_NAME# of #HOLDER_ADD_LINE_1#, #HOLDER_ADD_LINE_2#, #HOLDER_ADD_LINE_3#,
#HOLDER_CITY#, #HOLDER_STATE# #HOLDER_ZIP# (hereinafter “the holder), is hereby authorized to use
and occupy National Forest System lands, subject to the terms and conditions of this permit, to provide outfitting
of the
National Forest, legal description of permit area
and guiding services within the
is described as #TOWNSHIP_SECT_RANGE# #FIRST_DIVISION# #FIRST_DIV_NAME_NUMBER#,
#SECOND_DIVISION# #SECOND_DIV_NAME_NUMBER#, #THIRD_DIVISION#
#THIRD_DIV_NAME_NUMBER# and as shown on the map of the authorized area, attached as Appendix A. The
above-described area shall be referred to as the "permit area."
This permit is a
actitivities:

use permit issued for the purpose of authorizing the following outfitting and guiding

#PURPOSE#
and assigning use as follows:


priority use service days for
temporary use service days for
assigned sites
grazing use (in head months (HMs))
This use will be exercised as described in the
The following appendices are attached to and made a part of this permit:

APPENDIX A - Map of Authorized Area
APPENDIX B Operating Plan, dated
and approved annually
APPENDIX C - Trip Itinerary
APPENDIX D - Estimated Fee Determination Sheet, approved annually
APPENDIX E - Actual Use Report

APPENDIX F - Outfitter and Guide Performance Evaluation Form
APPENDIX G - Other
I.

AUTHORITY AND GENERAL TERMS OF THE PERMIT
A. AUTHORITY. This permit is issued pursuant to Federal Lands Recreation Enhancement Act, 16 U.S.C.
6802(h), and 36 CFR Part 251, Subpart B, as amended, and is subject to their provisions.
B. AUTHORIZED OFFICER. The authorized officer is the Forest Supervisor or a subordinate officer with
delegated authority.
C. TERM. This permit shall expire at midnight on #EXPIRATION_DATE#,
from the
date of issuance. Expiration of this permit shall not require notice, a decision document, or any
environmental analysis or other documentation.

Selection item 1: For policies with separate limits of coverage for personal injury or death
and third-party property damage, use the following clauses III.I, III.I.1, and III.1.2.
I. INSURANCE. The holder shall furnish proof of insurance, such as a certificate of insurance,
to the authorized officer prior to issuance of this permit and each year thereafter that this permit is
in effect. The Forest Service reserves the right to review and approve the insurance policy prior
to issuance. The holder shall send an authenticated copy of any insurance policy obtained
pursuant to this clause to the authorized officer immediately upon issuance of the policy. Any
insurance policies obtained by the holder pursuant to this clause shall name the United States as
an additional insured, and the additional insured provision shall provide for insurance coverage
for the United States as required under this clause. Such policies shall also specify that the
insurance company shall give 30 days prior written notice to the authorized officer of cancellation
of or any modification to the policies. The certificate of insurance, the authenticated copy of the
insurance policy, and written notice of cancellation or modification of insurance policies should be
. Minimum amounts of coverage and other insurance requirements are
sent to
subject to change at the sole discretion of the authorized officer on the anniversary date of this
permit.
1. Liability. The holder shall have in force liability insurance covering losses associated with the
use and occupancy authorized by this permit arising from personal injury or death and third-party
property damage in the minimum amount of:
$

for injury or death to one person per occurrence,

$

for injury or death to more than one person per occurrence, and

$

for third-party property damage, per occurrence.

2. Depending on the holder's operations, the Forest Service may require the holder to demonstrate
the availability of funds to address any release or threatened release of hazardous materials that
may occur in connection with the holder's use and occupancy. Any requirements imposed would
be established on a case-by-case basis by the authorized officer based on the degree of
environmental risk from the holder's operations. The use and storage of normal maintenance
supplies in nominal amounts generally would not trigger financial assurance requirements.
Selection item 2: For policies with combined single limits of coverage for personal injury
or death and third-party property damage, use the following clauses III.I, III.I.1, and III.I.2.
I. INSURANCE. The holder shall furnish proof of insurance, such as a certificate of insurance,
to the authorized officer prior to issuance of this permit and each year thereafter that this permit is
in effect. The Forest Service reserves the right to review and approve the insurance policy prior
to issuance. The holder shall send an authenticated copy of any insurance policy obtained

pursuant to this clause to the authorized officer immediately upon issuance of the policy. Any
insurance policies obtained by the holder pursuant to this clause shall name the United States as
an additional insured, and the additional insured provision shall provide for insurance coverage
for the United States as required under this clause. Such policies shall also specify that the
insurance company shall give 30 days prior written notice to the authorized officer of cancellation
of or any modification to the policies. The certificate of insurance, the authenticated copy of the
insurance policy, and written notice of cancellation or modification of insurance policies should be
. Minimum amounts of coverage and other insurance requirements are
sent to
subject to change at the sole discretion of the authorized officer on the anniversary date of this
permit.
1. Liability. The holder shall have in force liability insurance covering losses associated with the
use and occupancy authorized by this permit arising from personal injury or death and third-party
property damage in the minimum amount of $
occurrence.

as a combined single limit per

2. Depending on the holder's operations, the Forest Service may require the holder to demonstrate
the availability of funds to address any release or threatened release of hazardous materials that
may occur in connection with the holder's use and occupancy. Any requirements imposed would
be established on a case-by-case basis by the authorized officer based on the degree of
environmental risk from the holder's operations. The use and storage of normal maintenance
supplies in nominal amounts generally would not trigger financial assurance requirements.

Selection item 3: If the prospective holder is a federal agency, use the following clause
III.I. >
I. DAMAGE TO NATIONAL FOREST INTERESTS, PROPERTY, OR RESOURCES. As an
agency of the United States, the holder is limited by federal law as to the assumption of liability
for its acts or omissions. The holder agrees, within its legal limitations and limitations of
appropriations, to be responsible for all damages arising from injury to persons or property
associated with the use and occupancy authorized by this permit. The holder further agrees, to
the extent legally permissible, to use its appropriations and resources as required to pay any
claims and to repair damage to the land within the permit area. This provision is intended to
shield the appropriations of the Forest Service from any burdens, other than administrative costs,
which may arise in connection with the use and occupancy authorized by this permit.


IV. PERMIT FEES AND ACCOUNTING RECORDS
A. PERMIT FEE. The holder shall pay to the USDA, Forest Service, an annual permit fee for the
term of this permit based on the fair market value of the use and occupancy authorized by this
permit. The annual permit fee shall include a commercial use fee and, if applicable, an assigned
site fee and grazing fee, as enumerated in clauses IV.B, C, and D. The minimum annual permit
fee for the authorized use and occupancy shall be $

. Estimates of service days,

the number of assigned sites, and grazing use shall be determined from the five-year or annual
operating plan. Estimated fees shall be calculated on an Estimated Fee Determination Sheet.
The holder shall pay the annual permit fee in advance of the authorized use and occupancy, as
provided in clause IV.B. Payments due before commercial operations commence are not
refundable. The Forest Service shall adjust and calculate permit fees authorized by this permit to
comply with any new permit fee system based on market value that may be adopted by statute,
regulation or directive issued by the Chief after issuance of this permit.
1. COMMERCIAL USE FEE. The annual permit fee shall be determined in accordance with
. Any decrease in the assigned amount of use (non-use) must be approved by the
authorized officer. The holder does not have to pay a commercial use fee for approved non-use.
The holder shall pay a commercial use fee for any non-use that is not approved.
(a) Definitions
(1) Adjusted Gross Revenue. Gross revenue and revenue additions less applicable
exclusions.
(2) Gross Revenue. The total amount of receipts from the sale of goods or services provided by
the holder or third party under the permit.
(3) Revenue Additions. The market value of the following items, which are added to gross
revenue:
(A) The value of goods and services that are donated or the value of goods and services
that are bartered in exchange for goods and services received that are directly
related to the outfitted or guided trip; and
(B) The value of gratuities, which are goods, services, or privileges that are not available
to the general public and that are donated or provided without charge to
organizations; individuals; the holder's employees, owners, or officers; or immediate
family members of the holder's employees, owners, or officers.
(4) Revenue Exclusions. The following are excluded from gross revenue:
(A) Revenue derived from goods or services sold on private land that are not related to
outfitting and guiding operations conducted on National Forest System lands, such
as souvenirs, telephone toll charges, and accident insurance sales.
(B) Amounts paid or payable to a State government licensing authority or recreation
administering agency from sales of hunting or fishing licenses and recreation fee
tickets.
(C) Revenue from the sale of operating equipment, rental equipment, capitalized assets,
or other assets used in outfitting and guiding operations, such as horses, tack,
watercraft, and rental skis and boots, which are sold periodically and replaced.
2. ASSIGNED SITE FEE. A fee shall be charged for the occupancy of National Forest System sites
assigned to the holder. Assigned site fees shall not be prorated; the holder shall pay the full
annual fee for each assigned site. No refunds or credits will be given for authorized but unused
assigned sites.
3. GRAZING FEE. A fee shall be charged for grazing livestock used in conjunction with the use and
occupancy authorized by this permit. No refunds or credits will be given for authorized but
unexercised grazing use.
B. PAYMENT SCHEDULE. The holder shall pay the annual estimated permit fee, including the fee
for commercial use, assigned site fee, and grazing fee, in advance of the authorized use, as
follows:
1. Single Payment. The holder shall pay the total annual estimated fee in advance when it is less
than $500.

2. Two Payments. The holder shall pay half the total annual estimated fee in advance and the
remainder by mid-season when the total is equal to or greater than $500, but less than $2,500.
3. Three Payments. The holder shall pay one-third of the total annual estimated fee in advance
and the remainder in two equal payments by mid-season when the total is $2,500 or more.
4. Final Payment. The Forest Service shall reconcile annually the actual permit fee against permit
fee payments made. The holder shall pay any additional fees owed for the past year’s operation
within 30 days of billing.
C. DOCUMENTATION OF REVENUE. The holder shall provide documentation of use and revenue
for purposes of permit fee verification.
1. Actual Use Report. Within 30 days of completion of the holder's approved operating season, the
holder shall submit to the authorized officer an actual use report in accordance with the format in
Appendix E.
2. Income Statements. No later than 90 days after the close of the holder's fiscal year, the holder
shall submit to the authorized officer a statement of income reporting the results of the holder's
annual operations. The statement shall include gross revenue, the value of donated goods and
services, the value of gratuities, the value and description of items excluded from gross revenue,
and all adjustments, such as taxes deducted, and shall be broken down by permitted activities.
D.

FEE PAYMENT ISSUES
1. Crediting of Payments. Payments shall be credited on the date received by the deposit facility,
except that if a payment is received on a non-workday, the payment shall not be credited until the
next workday.
2. Disputed Fees. Fees are due and payable by the due date. Disputed fees must be paid in full.
Adjustments will be made if dictated by settlement terms or an appeal decision.
3. Late Payments
(a) Interest. Pursuant to 31 U.S.C. 3717 et seq., interest shall be charged on any fee amount
not paid within 30 days from the date it became due. The rate of interest assessed shall be
the higher of the Prompt Payment Act rate or the rate of the current value of funds to the
Treasury (i.e., the Treasury tax and loan account rate), as prescribed and published annually
or quarterly by the Secretary of the Treasury in the Federal Register and the Treasury Fiscal
Requirements Manual Bulletins. Interest on the principal shall accrue from the date the fee
amount is due.
(b) Administrative Costs. If the account becomes delinquent, administrative costs to cover
processing and handling the delinquency shall be assessed.
(c) Penalties. A penalty of 6% per annum shall be assessed on the total amount that is more
than 90 days delinquent and shall accrue from the same date on which interest charges
begin to accrue.
(d) Termination for Nonpayment. This permit shall terminate without the necessity of prior
notice and opportunity to comply when any permit fee payment is 90 calendar days from the
due date in arrears. The holder shall be responsible for the delinquent fees, as well as any
other costs of restoring the site to its original condition, including hazardous waste cleanup.
4. Administrative Offset and Credit Reporting. Delinquent fees and other charges associated
with the permit shall be subject to all rights and remedies afforded the United States pursuant to
31 U.S.C. 3711 et seq. and common law. Delinquencies are subject to any or all of the following:
(a) Administrative offset of payments due the holder from the Forest Service.
(b) If in excess of 60 days, referal to the Department of the Treasury for appropriate collection
action as provided by 31 U.S.C. 3711(g)(1).
(c) Offset by the Secretary of the Treasury of any amount due the holder, as provided by 31
U.S.C. 3720 et seq.

(d) Disclosure to consumer or commercial credit reporting agencies.
E. ACCOUNTING RECORDS. The holder shall follow generally accepted accounting principles or
another comprehensive basis of accounting, such as the cash, modifed cash, or income tax basis
of accounting, in recording financial transactions. The minimum acceptable accounting system
shall include:
1. Systematic internal controls and separate recording of gross receipts from each type of business
conducted under this permit, separate from any other commercial or personal activity. Receipts
shall be recorded daily without reduction and, if possible, deposited into a bank account. Receipt
entries shall be supported by documentation such as cash register tapes, sales invoices,
reservation records, and cash accounts from other sources.
2. For permits with fees greater than $10,000, when requested by the Forest Service, the holder at
its own expense shall have its annual accounting records audited by an independent public
accountant acceptable to the Forest Service.
F. ACCESS TO ACCOUNTING RECORDS. The holder shall make all of the accounting books and
supporting records for the business activities authorized by this permit available for audit by the
Forest Service or other federal agencies authorized to review Forest Service activities. The
holder shall retain these records and make them available for review for five years after the end
of the year they were generated, unless disposition is otherwise authorized by the Forest Service
in writing.
V.

RESOURCE PROTECTION
A. COMPLIANCE WITH ENVIRONMENTAL LAWS. The holder shall in connection with the use
and occupancy authorized by this permit comply with all applicable federal, state, and local
environmental laws and regulations, including but not limited to those established pursuant to the
Resource Conservation and Recovery Act, as amended, 42 U.S.C. 6901 et seq., the Federal
Water Pollution Control Act, as amended, 33 U.S.C. 1251 et seq., the Oil Pollution Act, as
amended, 33 U.S.C. 2701 et seq., the Clean Air Act, as amended, 42 U.S.C. 7401 et seq., the
Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as
amended, 42 U.S.C. 9601 et seq., the Toxic Substances Control Act, as amended, 15 U.S.C.
2601 et seq., the Federal Insecticide, Fungicide, and Rodenticide Act, as amended, 7 U.S.C. 136
et seq., and the Safe Drinking Water Act, as amended, 42 U.S.C. 300f et seq.
B. VANDALISM. The holder shall take reasonable measures to prevent and discourage vandalism
and disorderly conduct and when necessary shall contact the appropriate law enforcement
officer.
C. HERBICIDE AND PESTICIDE USE. Herbicides and pesticides may not be used to control
undesirable woody and herbaceous vegetation, aquatic plants, insects, rodents, fish, and other
pests and weeds without prior written approval from the authorized officer. A request for approval
of planned uses of pesticides shall be submitted annually by the holder on the due date
established by the authorized officer. The report shall cover a 12-month period of planned use
beginning 3 months after the reporting date. Information essential for review shall be provided in
the form specified. Exceptions to this schedule may be allowed, subject to emergency request
and approval, only when unexpected outbreaks of pests or weeds require control measures that
were not anticipated at the time an annual report was submitted. Only those materials registered
by the U.S. Environmental Protection Agency for the specific purpose planned shall be
considered for use on National Forest System lands. Label instructions and all applicable laws
and regulations shall be strictly followed in the application of pesticides and disposal of excess
materials and containers.
D. ARCHAEOLOGICAL-PALEONTOLOGICAL DISCOVERIES. The holder shall immediately
notify the authorized officer of any antiquities or other objects of historic or scientific interest,
including but not limited to historic or prehistoric ruins, fossils, or artifacts discovered as the result
of operations under this permit. The holder shall leave such discoveries intact until authorized to
proceed by the authorized officer. Protective and mitigative measures specified by the authorized
officer shall be the responsibility of the holder.

E. PROTECTION OF HABITAT OF ENDANGERED, THREATENED, AND SENSITIVE SPECIES.
Location of areas needing special measures for protection of plants or animals listed as
threatened or endangered under the Endangered Species Act (ESA), 16 U.S.C. 531 et seq., as
amended, or as sensitive by the Regional Forester under the authority of Forest Service Manual
Chapter 2670, derived from ESA Section 7 consultation, may be shown on a separate map,
hereby made a part of this permit, or identified on the ground. Protective and mitigative
measures specified by the authorized officer shall be the sole responsibility of the holder. If
protective measures prove inadequate, if other such areas are discovered, or if new species are
listed as federally threatened or endangered or as sensitive by the Regional Forester, the
authorized officer may specify additional protection, regardless of when such facts become
known. Discovery of such areas by either party shall be promptly reported to the other party.
F. CONSENT TO STORE HAZARDOUS MATERIALS. The holder shall not store any hazardous
materials at the site without prior written approval from the authorized officer. This approval shall
not be unreasonably withheld. If the authorized officer provides approval, this permit shall
include, or in the case of approval provided after this permit is issued, shall be amended to
include specific terms addressing the storage of hazardous materials, including the specific type
of materials to be stored, the volume, the type of storage, and a spill plan. Such terms shall be
proposed by the holder and are subject to approval by the authorized officer.

1. If the holder receives consent to store hazardous material, the holder shall identify to the
Forest Service any hazardous material to be stored at the site. Such identification information
shall be consistent with column (1) of the table of hazardous materials and special provisions
given at 49 CFR 172.101 whenever the hazardous material appears in that table. For hazard
communication purposes, the holder shall maintain Material Safety Data Sheets for any stored
hazardous chemicals, consistent with 29 CFR 1910.1200(c) and (g). In addition, all hazardous
materials stored by the holder shall be used, labeled, stored, transported, and disposed of in
accordance with all applicable federal, state, and local laws and regulations.
2. The holder shall not release any hazardous material as defined in clause III.F. onto land or into
rivers, streams, impoundments, or into natural or man-made channels leading thereto. All
prudent and safe attempts must be made to contain any release of these materials. The
authorized officer in charge may specify specific conditions that must be met, including conditions
more stringent than federal, state, and local regulations, to prevent releases and protect natural
resources.
Selection item 2: Select to remove selection item 1 and have nothing appear.

G. CLEANUP AND REMEDIATION.
1. The holder shall immediately notify all appropriate response authorities, including the National
Response Center and the authorized officer, of any oil discharge or of the release of a hazardous
substance at the site in an amount greater than or equal to its reportable quantity, in accordance
with 33 CFR Part 153, Subpart B, and 40 CFR Part 302. For the purposes of this requirement,
“oil” is as defined by section 311(a)(1) of the Clean Water Act, 33 U.S.C. 1321(a)(1). The holder
shall immediately notify the authorized officer upon knowledge of any release or threatened
release of any hazardous material at or in the vicinity of the permit area which may be harmful to
public health or welfare or which may adversely affect natural resources under the management
of the United States.
2. Except with respect to any federally permitted release as that term is defined under Section
101(10) of CERCLA, 42 U.S.C. 9601(10), the holder shall clean up or otherwise remediate any
release, threat of release, or discharge of hazardous materials that occurs either on site or in
connection with the holder's activities, whether or not those activities are authorized under this
permit. The holder shall perform cleanup or remediation immediately upon discovery of the
release, threat of release, or discharge of hazardous materials. The holder shall perform the

cleanup or remediation to the satisfaction of the authorized officer and at no expense to the
United States. Upon revocation or termination of this permit, the holder shall deliver the site to
the Forest Service free and clear of contamination.

H. CERTIFICATION UPON REVOCATION OR TERMINATION. If the holder uses or stores
hazardous materials at the site, upon revocation or termination of this permit the holder shall
provide the Forest Service with a report certified by a professional or professionals acceptable to
the Forest Service that the site covered by this permit is uncontaminated by the presence of
hazardous materials and that there has not been a release or discharge of hazardous materials
upon the site, into surface water at or near the site, or into groundwater below the site during the
term of the permit. This certification requirement may be waived by the authorized officer when
the Forest Service determines that the risks posed by the hazardous material are minimal. If a
release or discharge has occurred, the professional or professionals shall document and certify
that the release or discharge has been fully remediated and that the site is in compliance with all
federal, state, and local laws and regulations.

VI.

REVOCATION, SUSPENSION, AND TERMINATION
A. REVOCATION AND SUSPENSION. The authorized officer may revoke or suspend this permit in
whole or in part:
1. For noncompliance with federal, state, or local laws and regulations;
2. For noncompliance with the terms of this permit;
3. For failure of the holder to exercise the privileges granted by this permit;
4. With the consent of the holder; or
5. At the discretion of the authorized officer, for specific and compelling reasons in the public
interest.
B. REVOCATION BASED ON PERFORMANCE RATING. If the holder receives an annual rating of
unacceptable based on deficiencies identified but uncorrected in a mid-season review and
evaluation, the Forest Service shall revoke this permit or, if it is about to expire, shall allow it to
terminate.
C. NOTICE AND OPPORTUNITY TO TAKE CORRECTIVE ACTION. Prior to revocation or
suspension under clause VI.A. or VI.B, the authorized officer shall give the holder written notice of
the grounds for the action to be taken. For purposes of revocation under clause VI.B, written
notice must be given to the holder after the mid-season review and evaluation that if the identified
deficiencies are not corrected, they will result in an annual rating of unacceptable, which in turn
will result in revocation of the permit. Prior to revocation or suspension under clause VI.A.1, 2, or
3 or revocation under clause VI.B, the authorized officer also shall give the holder a reasonable
period, not to exceed 30 days, to complete corrective action prescribed by the authorized officer.
The period between the mid-season review and evaluation and the annual rating shall constitute
adequate opportunity to take corrective action for purposes of revocation under clause VI.B.

Selection item 1: Use for short operating seasons where a mid-term evaluation is not
feasible.
C. NOTICE AND OPPORTUNITY TO TAKE CORRECTIVE ACTION. Prior to revocation or
suspension under clause VI.A. or VI.B, the authorized officer shall give the holder written notice of
the grounds for the action to be taken. For purposes of revocation under clause VI.B, written
notice must be given to the holder after a review and evaluation that if the identified deficiencies
are not corrected, they will result in an annual rating of unacceptable, which in turn will result in

revocation of the permit. Prior to revocation or suspension under clause VI.A.1, 2, or 3 or
revocation under clause VI.B, the authorized officer also shall give the holder a reasonable
opportunity to complete corrective action prescribed by the authorized officer. The period
between the review and evaluation and the annual rating shall constitute adequate opportunity to
take corrective action for purposes of revocation under clause VI.B.
Selection item 2: Select to remove selection 1 and to have nothing appear.

D. IMMEDIATE SUSPENSION. The authorized officer may immediately suspend this permit in
whole or in part when necessary to protect public health or safety or the environment. The
suspension decision must be in writing. Within 48 hours of the request of the holder, the superior
of the authorized officer shall arrange for an on-the-ground review of the adverse conditions with
the holder. Following this review, the superior shall take prompt action to affirm, modify, or cancel
the suspension.
E. APPEALS AND REMEDIES. Any written decisions by the authorized officer relating to
administration of this permit, including annual ratings of probationary and unacceptable and
revocation or suspension decisions, are subject to the administrative appeal regulations at 36
CFR Part 251, Subpart C, as amended. Revocation or suspension of this permit shall not give
rise to any claim for damages by the holder against the Forest Service.
F. TERMINATION. This permit shall terminate when by its terms a fixed or agreed upon condition,
event, or time occurs without any action by the authorized officer. Examples include but are not
limited to expiration of the permit by its terms on a specified date and termination upon change of
control of the business entity. Termination of this permit is not subject to administrative appeal
and shall not give rise to any claim for damages by the holder against the Forest Service.
G. REMOVAL OF TEMPORARY IMPROVEMENTS. Upon revocation or termination of this permit,
the holder shall remove within a reasonable time prescribed by the authorized officer all
temporary improvements, except those owned by the United States, and shall restore the site. If
the holder fails to remove all temporary improvements within the prescribed period, they shall
become the property of the United States and may be sold, destroyed, or otherwise disposed of
without any liability to the United States. However, the holder shall remain liable for all costs
associated with their removal, including costs of sale and impoundment, cleanup, and restoration
of the site.

VII. MISCELLANEOUS PROVISIONS
A. ADVERTISING. The holder shall not misrepresent in any way, either orally, in its circulars,
brochures, advertising, and other materials, or on its World Wide Web site, signs, or letterheads,
any aspect of the use authorized by this permit, including services provided by the holder, the
status of this permit, or the area it covers. All of the holder's circulars, brochures, and advertising
and its World Wide Web site regarding use of the permit area shall state that the permit area is
located in the

National Forest.

B. CURRENT ADDRESSES. The holder and the Forest Service shall keep each other informed of
current mailing addresses, including those necessary for payment of fees.
C. SERVICES NOT PROVIDED. This permit does not provide for the furnishing of road or trail
maintenance, water, fire protection, search and rescue, or any other such service by a
government agency, utility, association, or individual.
D. MEMBERS OF CONGRESS. No member of or delegate to Congress or resident commissioner
shall benefit from this permit either directly or indirectly, except to the extent the authorized use
provides a general benefit to a corporation.


G. SUPERSEDED PERMIT. This permit supersedes a permit designated
#PREV_REISSUE_HOLDER#,

, and dated #PREV_REISSUE_DATE#.

H. SUPERIOR CLAUSES. In the event of any conflict between any of the preceding printed clauses and
any subsequent clauses or any provisions in the appendices attached to this permit, the preceding
printed clauses shall control.
#INSERT TERM HERE#
This permit is accepted subject to all its terms and conditions.



HOLDER: #HOLDER_NAME#

U.S. DEPARTMENT OF AGRICULTURE
Forest Service

By:

By: __________________

(Holder or Holder’s Agent)
Date: ________________
_____________

(Authorized Officer)
Date:

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instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information.
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received by the Forest Service.



HOLDER: #HOLDER_NAME#

U.S. DEPARTMENT OF AGRICULTURE

By:
(Holder or Holder’s Agent)

By: __________________
(Authorized Officer)

Date:
_____________

Date:

The following certificate shall be executed by the secretary or assistant secretary of the corporation:
I,

, certify that I am the

of the corporation that executed the above permit; that

, who signed this permit on behalf of
was then
of that corporation;
that I know his/her signature; that his/her signature on this permit is genuine; and that this permit was signed,
sealed, and attested to on behalf of

by authority of its board of directors.

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 1 hour 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 TitleUse Code: 153
AuthorFSDefaultUser
File Modified2006-09-27
File Created2006-09-27

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