USDA Forest Service                                                                                                                                    OMB 0596-0016                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         	
APPLICATION FOR PERMIT
NON-FEDERAL COMMERCIAL USE OF ROADS RESTRICTED BY ORDER
(Reference to FSM 7730)	

NOTE:	This report is authorized by Acts of June 10, 1914; April 24, 1950; June 12, 1960, and October 13, 1964 
               (USC 478,572,530 and 532-38).  No permit may be issued unless a completed Form 7700-40 is received.	
For Official Use Only	DATE OF APPLICATION	
REGION
     	STATE
     	COUNTY
     	FOREST
     	RANGER DISTRICT
     	
     	

1.	APPLICANT (Name, address, and Zip Code)                                                                 TELEPHONE NUMBER
                                                                                                                                                 (   )     -     
          
          

2.	DESCRIPTION AND MILEAGE OF ROAD(S) OR ROAD SEGMENT(S) TO BE USED (as shown on attached map)
          

3.	PURPOSE OF USE                                                    
                                                      HAULING LOGS OR LUMBER         MBF
                                                                                                         (Quantity)
                                                     
                                                      HAULING OTHER MATERIALS        TONS
                                                                                                            (Quantity)
	
              DESCRIBE MATERIALS      

	

4.	USE SCHEDULE

                                      NUMBER OF DAYS                    TYPE OF TRUCKS                           TYPE OF LOADING
         SEASON                       OF USE                                   TO BE USED                                     TO BE USED
                                                                                                                                    
                                                                                                                                    
                                                                                                                                    
                                                                                                                                    

	
5.	PLANS FOR FUTURE USE (Not applied for on this application)

                                                          HAULING LOGS OR LUMBER         MBF
                                                                                                             (Estimated Quantity)
                                                          HAULING OTHER MATERIALS        TONS
                                                                                                             (Estimated Quantity)
	
              DESCRIBE MATERIALS      
	  
              ESTIMATED PERIOD OF USE FROM          TO        	
SIGNATURE OF APPLICANT

	DATE 
     	
Page 1 of 2	FS-7700-40(8/95) 	
USDA Forest Service                                                                                                                                                      OMB 0596-0016
REPORT ON APPLICATION
(To Be Completed By District Ranger)
	
1.	GENERAL DESCRIPTION AND ADAPTABILITY OF ROAD(S) FOR PROPOSED USE. (Show road(s) on 1/2" Forest Transportation Map)
           
	
2.	IMPROVEMENTS FOR BETTERMENT WORK NEEDED ON ROAD(S) TO SAFELY ACCOMMODATE THE ADDITIONAL TRAFFIC
             
	
3.	IMPROVEMENTS OR BETTERMENT WORK DESIRED
            
	
4.	RECOMMENDATION OR COMMENTS (Include any factors which might affect the granting of the hauling permit or future use of the road(s).)
             

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 0596-0016.  The time required to complete this information collection is estimated to average 15 minutes per response, including the time reviewing for the instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information. 	
  REPORT SUBMITTED

       	NAME AND SIGNATURE

	TITLE

     	DATE

     	
REPORT APPROVED

     	NAME AND SIGNATURE	TITLE

     	DATE

     	
Page 2 of 2			FS 7700-40(8/95)