FS-2700-4d Special Use Permit for a Temporary Road Covered by a Cos

Authorization ID: #AUTH_ID#
Contact ID: #HOLDER_ID#
Expiration Date: #EXPIRATION_DATE#
Use Code: #USE_CODE#

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

U.S. DEPARTMENT OF AGRICULTURE
Forest Service
SPECIAL USE PERMIT FOR A TEMPORARY ROAD COVERED BY A COST SHARE AGREEMENT
AUTHORITY:
#AUTHORITY_NAME#
#HOLDER_NAME#, #HOLDER_ADD_LINE_1#, #HOLDER_ADD_LINE_2#, #HOLDER_ADD_LINE_3#,
#HOLDER_CITY#, #HOLDER_STATE# #HOLDER_ZIP# (hereafter called the holder) is hereby authorized to
use National Forest lands for the construction, reconstruction, maintenance, and use of a road within the
National Forest for the protection, administration, management, and utilization of lands and the
resources thereof now or hereafter owned or controlled by the holder. The lands covered by this permit are
located in the County of

State of

and are described as follows:

#PURPOSE#
#TOWNSHIP_SECT_RANGE#
#FIRST_DIVISION# #FIRST_DIV_NAME_NUMBER#, #SECOND_DIVISION#
#SECOND_DIV_NAME_NUMBER#, #THIRD_DIVISION# #THIRD_DIV_NAME_NUMBER#
This permit covers a right-of-way #ROW_LENGTH_MILES# miles in length, #ROW_WIDTH_FEET# feet in width,
containing approximately #ROW_ACRES# acres, and is located upon the ground according to the survey line,
figures, measurements, widths, and other references shown on the plat attached hereto and made a part hereof.
This permit is made subject to the following terms, provisions, and conditions:
1. This permit is subject to all valid rights existing on this date.
2. The holder, in exercising the privileges granted by this permit, shall comply with all applicable State and
Federal laws, Executive Orders, and Federal rules and regulations.
3. The holder shall cut only such timber as necessary in clearing for road construction, reconstruction, and
maintenance. Timber so cut shall, unless otherwise agreed to, be cut into logs of lengths specified by the Forest
Service and decked along the road for disposal by the Forest Service.
4. The holder shall do everything reasonably within its power to prevent forest fires and shall not dispose of
material by burning in open fires during the closed season established by law or regulation without a written
permit from the Forest Service.
5. The holder shall repair fully all damage to National Forest roads and trails caused by the holder in exercise of
the privileges granted by this permit.
6. No member of or delegate to Congress or resident commissioner shall be admitted to any share or part of this
agreement or to any benefit that may arise herefrom unless it is made with a corporation for its general benefit.
7. In consideration for this use, the holder has granted reciprocal rights-of-way to the United States.
8. Construction of the road shall be in accordance with the specifications set forth in exhibit
attached hereto.

,

9. The holder shall provide maintenance so that the road will be in a condition equal to that normally prevailing on
roads of like standard, and unless otherwise agreed to, shall construct leadoff drainage and water barriers to
prevent erosion on the road as directed by the Forest Service.

10. Use of roads constructed under authority of this permit shall be subject to control by the holder, except that
the roads shall at all times be open to use by Forest Service employees on official business.
11. The holder shall maintain the right-of-way clearing by means of chemicals only after the Regional Forester
has given specific written approval. Application for such approval must be in writing and must specify the time,
method, chemicals and the exact portion of the right-of-way to be chemically treated.
12. In the event the road constructed on the right-of-way herein is included in a subsequent cooperative
agreement for joint construction, the Government shall treat the holder's construction costs as incurred under the
agreement. In this event, the Government shall replace this permit with an easement as provided by regulations
of the Secretary of Agriculture (36 CFR 212.10c).
13. This permit may be terminated or suspended upon breach of any of the conditions herein or at the discretion
of the Regional Forester or the Chief, Forest Service.
14. Unless sooner terminated in accordance with the provisions of the permit, or revoked by the Regional
Forester, this permit shall expire and become void on #EXPIRATION_DATE#.
#INSERT TERM HERE#

In Witness Whereof, the parties hereto have caused this permit to be duly executed on this

day

.

Holder
By:

USDA - Forest Service
BY:

#HOLDER_NAME#
Forest Supervisor
National Forest

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