FS-2700-23 Amendment for Special Use Authorization

USDA - Forest Service

FS-2700-23 (03/06)
OMB No. 0596-0082

AMENDMENT
FOR
SPECIAL-USE AUTHORIZATION

Holder No.

Type Site

Authority

Issue Date

Expir. Date

Region

Forest

District

State/County

This amendment is attached to and made a part of the
authorization for

issued to

special use

on

which is hereby amended as follows:

This Amendment is accepted subject to the conditions set forth herein, and to conditions

to

attached hereto and made a part of this Amendment.
Holder:

Authorized Officer
Title:

Holder:
Date:

(mm/dd/yyyy)

Date:

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Forest Service.

USDA - Forest Service

FS-2700-23 (03/06)
OMB No. 0596-0082