FS-2700-4b Forest Road Special Use Permit

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

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

U.S. DEPARTMENT OF AGRICULTURE
Forest Service
FOREST ROAD SPECIAL USE PERMIT
AUTHORITY
#AUTHORITY_NAME#

#HOLDER_NAME# of #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
the following described National Forest Development Road within the
for the following purposes:

National Forest

#PURPOSE#
The road covered by this permit is located in the County of
, State of
, and is shown on
the attached map and identified as follows: #TOWNSHIP_SECT_RANGE# #FIRST_DIVISION#
#FIRST_DIV_NAME_NUMBER#, #SECOND_DIVISION# #SECOND_DIV_NAME_NUMBER#,
#THIRD_DIVISION# #THIRD_DIV_NAME_NUMBER#
This permit authorizes use of approximately #USE_MILES# miles of road.
THIS PERMIT IS MADE SUBJECT TO THE FOLLOWING TERMS, PROVISIONS, AND CONDITIONS:
1. This permit is subject to all existing easements and valid rights existing on this date.
2. Holder shall comply with applicable Federal or State law and shall comply with State standards for public
health and safety, environmental protection, and siting construction, operation, and maintenance if those
standards are more stringent than applicable Federal standards.
3. The holder shall cut no timber except as authorized by construction stipulations or maintenance agreements.
4. Holder shall pay the United States for all injury, loss, or damage, including fire suppression costs, in
accordance with Federal and State laws and regulations.
5. Holder shall indemnify the United States for any and all injury, loss, or damage, including fire suppression
costs the United States may suffer as a result of claims, demands, losses, or judgments caused by the holder's
use or occupancy under this permit.
6. Holder shall pay annually in advance a sum determined by the Forest Service to be the fair market value of the
use authorized by this permit. The initial payment is set at

for the remainder of the calendar year.

adjusted using the Implicit
Payments for each subsequent calendar year shall be the amount of
Price Deflator-Gross National Product index (IPD-GNP), or other factor selected by the Forest Service, to reflect
more nearly the current fair market value of the use. At intervals to be determined by certain changes in the
indexes used to establish the linear rights-of-way fee schedule, the fee shall be reviewed and adjusted as
necessary to assure that it is commensurate with the value of the rights and privileges authorized. In addition to
the annual payment, the holder shall pay its proportionate share of road costs prior to using the road for
commercial use. Failure of the holder to pay the annual payment, late charges, or other fees or charges shall
cause the permit to terminate.
7. Late Payment Interest, Administrative Costs and Penalties. 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 the fee or fee calculation financial statement

specified in this authorization becomes due. The rate of interest assessed shall be the higher of the rate of the
current value of funds to the U.S. Treasury (i.e., Treasury tax and loan account rate), as prescribed and published
by the Secretary of the Treasury in the Federal Register and the Treasury Fiscal Requirements Manual Bulletins
annually or quarterly or at the Prompt Payment Act rate. Interest on the principal shall accrue from the date the
fee or fee calculation financial statement is due.
In the event the account becomes delinquent, administrative costs to cover processing and handling of the
delinquency will be assessed.
A penalty of 6 percent per annum shall be assessed on the total amount delinquent in excess of 90 days and shall
accrue from the same date on which interest charges begin to accrue.
Payments will be credited on the date received by the designated collection officer or deposit location. If the due
date for the fee or fee calculation statement falls on a non-workday, the charges shall not apply until the close of
business on the next workday.
Disputed fees are due and payable by the due date. No appeal of fees will be considered by the Forest Service
without full payment of the disputed amount. Adjustments, if necessary, will be made in accordance with
settlement terms or the appeal decision.
If the fees become delinquent, the Forest Service will:
Liquidate any security or collateral provided by the authorization.
If no security or collateral is provided, the authorization will terminate and the holder will be responsible for
delinquent fees as well as any other costs of restoring the site to it's original condition including hazardous waste
cleanup.
Upon termination or revocation of the authorization, delinquent fees and other charges associated with the
authorization will be subject to all rights and remedies afforded the United States pursuant to 31 U.S.C. 3711 et
seq. Delinquencies may be subject to any or all of the following conditions:
Administrative offset of payments due the holder from the Forest Service.
Delinquencies in excess of 60 days shall be referred to United States Department of Treasury for appropriate
collection action as provided by 31 U.S.C. 3711 (g), (1).
The Secretary of the Treasury may offset an amount due the debtor for any delinquency as provided by 31
U.S.C. 3720, et seq.)
8. Holder shall pay the Forest Service for its share of maintenance cost or perform maintenance, as determined
by the Forest Service for all commercial use of the road. The maintenance obligation of the holder shall be
proportionate to total use and commensurate with its use. Any maintenance to be performed by the holder shall
be authorized by and shall be performed in accordance with an approved maintenance plan. In the event the
road requires maintenance, restoration, or reconstruction work to accommodate the holder's needs, the Forest
Service shall authorize the work required in the same manner as provided herein for maintenance or in clause 10
for reconstruction. The holder shall perform such work at its own expense.
9. The exercise of the use permitted shall be subordinate to any easement on said road subsequently granted by
the United States to a public road agency for operation as a public highway.
10. Any construction or reconstruction of the road shall be in accordance with plans, specifications, and written
stipulations approved by the Forest Service prior to beginning such construction or reconstruction.
11. The United States shall have unrestricted use of the road and right-of-way for all purposes deemed
necessary or desirable in connection with the protection, administration, management, and utilization of Federal
lands or resources, and it shall have the right alone to extend rights and privileges for use of the right-of-way and
road thereon to States and local subdivisions thereof and to other users including members of the public, except

users of land or resources owned or controlled by the holder. The Forest Service shall control such use to avoid
unreasonable interference with use of the road by the holder.
12. The Forest Service may relocate the road to the extent necessary to accommodate the management needs
of the National Forests.
13. This permit may be terminated or suspended upon breach of any of the conditions herein, or revoked at the
discretion of the Regional Forester.
USER NOTES CLAUSE 14
Alternative wordings may be substituted for the standard clause as noted in FSH 2709.12, sec. 43.
Review the selections for the clause that is most applicable and make your selection.
Selection item 1. Below is the standard clause for this permit.
14. Unless sooner terminated in accordance with the provisions of the permit, or revoked by the Regional
Forester, this permit shall expire and terminate on #EXPIRATION_DATE#. The permit shall not be reissued.
Selection item 2. Alternative wording 1.
14. Unless sooner terminated, or revoked by the Regional Forester, this permit shall expire and terminate on
#EXPIRATION_DATE#. At that time, if the holder still needs the road for the purposes for which this permit is
granted, the permit will be reissued for a period of 10 years (or the estimated remaining life of the project,
whichever is less). At the time of re-issuance, the terms and conditions may be modified and new conditions or
stipulations added at the discretion of the Forest Service.
Selection item 3. Alternative wording 2.
Note: If this clause is selected, remove the expiration date from top of form; leave the expiration date
field blank in the authorization screen.
14. Unless sooner terminated, or revoked by the Regional Forester, this permit shall continue as long as
needed for access to the

.

15. Nonexclusive Use and Public Access. Unless expressly provided for in additional terms, use of the permit
area is not exclusive. The Forest Service reserves the right to use or allow others to use any part of the permit
area, including roads, for any purpose, provided, such use does not materially interfere with the holder's
authorized use. A final determination of conflicting uses is reserved to the Forest Service.
16. Forest Service Right of Entry and Inspection. The Forest Service has the right of unrestricted access of the
permitted area or facility to ensure compliance with laws, regulations, and ordinances and the terms and condition
of this permit.
17. Liability. For purposes of this section, "holder" includes the holder's heirs, assigns, agents, employees, and
contractors.
A. The holder assumes all risk of loss to the authorized improvements.
B. The holder shall indemnify, defend, and hold the United States harmless for any violations incurred under
any such laws and regulations or for judgments, claims, or demands assessed against the United States in
connection with the holder's use or occupancy of the property. The holder's indemnification of the United
States shall include any loss by personal injury, loss of life or damage to property in connection with the
occupancy or use of the property during the term of this permit. Indemnification shall include, but is not
limited to, the value of resources damaged or destroyed; the costs of restoration, cleanup, or other mitigation;
fire suppression or other types of abatement costs; third party claims and judgments; and all administrative,
interest, and other legal costs. This paragraph shall survive the termination or revocation of this authorization,
regardless of cause.

USER NOTES FOR "C" CLAUSE
Selection item 1. This selection is the default liability clause for all authorizations. Use this clause when one
of the following conditions exist: (1) The holder is NOT a Federal Agency, State or political subdivision
thereof; (2) the authorized officer determines that the risk to public land, resources, or interest is NOT greater
than the holder's assets or ability to correct and; (3) the use is NOT a high-risk or poses a high hazard (such
as high-voltage power lines, oil and gas pipelines, large dams or reservoirs, and so forth, which could expose
the government to significant injuries, losses or damages in the event of malfunction).
C. The holder has an affirmative duty to protect from damage the land, property, and interests of the
United States.
Selection item 2. Use in situations in which the authorized officer determines that the risk to public land,
resources, or interest is greater than the holder's assets or ability to correct.
If holder is a State or political subdivision thereof and such entity has statutory or constitutional authorities
limiting the amount of liability or indemnification payable, the authorized officer shall prepare a risk
assessment to determine the United States potential for losses due to personal injury, loss of life, or property
damage caused by the State's use or occupancy. If the authorized officer determines, through the risk
assessment that the potential for injury, loss, or damage caused by the State's use or occupancy is in excess
of the State's liability limitation, the State shall procure, as a requirement to be fulfilled before execution of this
permit, insurance, and name the United States, together with the State, as an insured on the policy(ies), in the
amount determined in the risk assessment that exceeds the State's liability limitation.
C. The holder has an affirmative duty to protect from damage the land, property, and interests of the
United States.
The holder shall maintain #LIAB_INS_AMOUNT# worth of insurance coverage, naming the United States
additionally insured on the policies(s), to partially fund the indemnification obligations of the holder for any and
all losses due to personal injury, loss of life, or property damage, including fire suppression and hazardous
waste costs. The holder shall furnish proof of insurance (such as a surety bond, or certificate of insurance) to
the authorized officer prior to execution of this permit and verify annually, and in writing, the insurance
obligation to the authorized officer. The authorized officer may allow the holder to replace, repair, restore, or
otherwise undertake necessary curative actions, to the satisfaction of the authorized officer, in order to
mitigate damages in addition to or as an alternative to monetary indemnification.
Selection item 3. Use if the authorized use is a high-risk or poses a high hazard (such as high-voltage
power lines, oil and gas pipelines, large dams or reservoirs, and so forth, which could expose the government
to significant injuries, losses, or damages in the event of malfunction).
C. The holder has an affirmative duty to protect from damage the land, property, and interests of the
United States.
The holder shall be strictly liable (liability without proof of negligence) to the United States for any injury, loss,
or damage arising under this authorization. Such strict liability shall be in the amount of $1 million unless the
Forest Supervisor determines at the time of issuance of this authorization that a lesser amount of strict liability
is appropriate based upon a risk assessment for the use authorized by this instrument. Liability for injury,
loss, or damage to the United States in excess of the prescribed amount of strict liability shall be determined
under the general law of negligence.
Selection item 4. Use if the authorized use is a high-risk or poses a high hazard (such as high-voltage
power lines, oil and gas pipelines, large dams or reservoirs, and so forth, which could expose the government
to significant injuries, losses, or damages in the event of malfunction) AND in situations in which the
authorized officer determines that the risk to public land, resources, or interest is greater than the holder's
assets or ability to correct.

If the holder is a State or political subdivision thereof and such entity has statutory or constitutional authorities
limiting the amount of liability or indemnification payable, the authorized officer shall prepare a risk
assessment to determine the United States potential for losses due to personal injury, loss of life, or property
damage caused by the State's use or occupancy. If the authorized officer determines, through the risk
assessment that the potential for injury, loss, or damage caused by the State's use or occupancy is in excess
of the State's liability limitation, the State shall procure, as a requirement to be fulfilled before execution of this
permit, insurance, and name the United States, together with the State, as an insured on the policy(ies), in the
amount determined in the risk assessment that exceeds the State's liability limitation.
C. The holder has an affirmative duty to protect from damage the land, property, and interests of the
United States.
The holder shall maintain #LIAB_INS_AMOUNT# worth of insurance coverage, naming the United States
additionally insured on the policies(s), to partially fund the indemnification obligations of the holder for any and
all losses due to personal injury, loss of life, or property damage, including fire suppression and hazardous
waste costs. The holder shall furnish proof of insurance (such as a surety bond, or certificate of insurance) to
the authorized officer prior to execution of this permit and verify annually, and in writing, the insurance
obligation to the authorized officer. The authorized officer may allow the holder to replace, repair, restore, or
otherwise undertake necessary curative actions, to the satisfaction of the authorized officer, in order to
mitigate damages in addition to or an as alternative to monetary indemnification.
The holder shall be strictly liable (liability without proof of negligence) to the United States for any injury, loss,
or damage arising under this authorization. Such strict liability shall be in the amount of $1 million unless the
Forest Supervisor determines at the time of issuance of this authorization that a lesser amount of strict liability
is appropriate based upon a risk assessment for the use authorized by this instrument. Liability for injury,
loss, or damage to the United States in excess of the prescribed amount of strict liability shall be determined
under the general law of negligence.
D. In the event of any breach of the conditions of this authorization by the holder, the authorized officer may,
on reasonable notice, cure the breach for the account at the expense of the holder. If the Forest Service at
any time pays any sum of money or does any act which will require payment of money, or incurs any
expense, including reasonable attorney's fees, in instituting, prosecuting, and/or defending any action or
proceeding to enforce the United States rights hereunder, the sum or sums so paid by the United States, with
all interests, costs and damages shall, at the election of the Forest Service, be deemed to be additional fees
hereunder and shall be due from the holder to the Forest Service on the first day of the month following such
election.
E. With respect to roads, the holder shall be proportionally liable for damages to all roads and trails of the
United States open to public use caused by the holder's use to the same extent as provided above, except
that liability shall not include reasonable and ordinary wear and tear.
F. The Forest Service has no duty to inspect the permit area or to warn of hazards and, if the Forest Service
does inspect the permit area, it shall incur no additional duty nor liability for identified or non-identified
hazards. This covenant may be enforced by the United States in a court of competent jurisdiction.
18. Members of Congress. No Member of or Delegate to Congress or Resident Commissioner shall benefit from
this permit either directly or indirectly, except when the authorized use provides a general benefit to a corporation.
19. Appeals and Remedies. Any discretionary decisions or determinations by the authorized officer are subject
to the appeal regulations at 36 CFR 251, Subpart C, or revisions thereto.
20. Assignability. This authorization is not assignable or transferable. If Holder, through death, voluntary
transfer, enforcement of contract, foreclosure, or other valid legal proceeding shall cease to be owner of the
above described real property accessed by the authorized road, this authorization shall terminate.
21. Superior Clauses. In the event of any conflict between any of the preceding printed clauses or any provision
thereof and any of the following clauses or any provision thereof, the preceding printed clauses shall control.

#INSERT TERM HERE#

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

day of

.

Holder USDA - Forest Service
By:

By:

#HOLDER_NAME#
Forest Supervisor
National Forest
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