Form 2740-1 Application for Land for Recreation or Public Purposes

Form 2740-1
(January 2013)

FORM APPROVED
OMB NO. 1004-0012
Expires: December 31, 2015

UNITED STAT E S
DEPARTMEN T O F THE IN TERIO R
BUREA U OF LAND MANAGEMEN T
AP P L I C AT I O N F O R L A N D F O R
RE CR E A T I O N O R P U BL I C P U RP OS E S
(Act of June 14 , 1926, as amended ; 43 U.S.C . 869; 869-4)

la. Applicant's name

Date

Home phone (include area code)

Business phone (include area code)

b. Address (include zip code)

2. Give legal description of lands applied for (include metes and bounds description, if necessary)
SUBDIVISION
TOWNSHIP
RANGE
SECTION

County of
3a. This application is for:
b. Proposed use is

Public Recreation

MERIDIAN

Containing (acres)

State of
Lease

Serial Number
(BLM use only)

Purchase (If lease, indicate year

)

Other Public Purposes

4. Describe the proposed use of the land. The description must specifically identify an established or definitely proposed project. Attach a detailed plan
and schedule for development, a management plan which includes a description of how any revenues will be used, and any known environmental or
cultural concerns specific to the land.

5. If applicant is State or Political subdivision thereof, cite your statutory or other authority to hold land for these purposes.

6. Attach a copy of your authority for filing this application and to perform all acts incident thereto.
7. If land described in this application has not been classified for recreation and/or public purposes pursuant to the Recreation and Public Purposes Act,
consider this application as a petition for such classification.

(Continued on page 2)

8. Are all activities, facilities, services, financial aid, or other benefits as a result of your proposed development provided without regard to race, color,
religion, national origin, sex, or age?
Yes
No (If "no," describe the situation or activity and your plans for achieving compliance.)

9. Are all activities, facilities, and services constructed or provided as a result of your proposed development accessible to and usable by persons with
disabilities?
Yes
No (If "no," describe the situation or activity and the reasons for nonaccessibility).

Date

Applicant's Signature

Title 18 U.S.C. Section 1001 and Title 43 U.S.C. Section 1212, make it a crime for any person knowingly and willfully to make to any department or
agency of the United States any false, fictitious, or fraudulent statements or representation as to any matter within its jurisdiction.

GENERAL INSTRUCTIONS
1. Type or print plainly in ink.
2. Submit application and related plans to the BLM District or Resource Area Office
in which the land is located.

3. Study controlling regulations in 43 CFR 2740 (Sales) and 43 CFR 2912 (Leases).
4. If applicant is non-governmental association or corporation, attach a copy of your
charter, articles of incorporation or other creating authority. If this information has
been previously filed with any BLM office, refer to previous filing by date, place,
and case serial number.
5. If applicant is non-governmental association or corporation, attach a copy of your
authority to operate in the State where the lands applied for are located. If
previously filed with any BLM office, refer to previous filing by date, place, and
case serial number.

SPECIFIC INSTRUCTIONS
(Items not listed are self - explanatory)
Item
2.

If land is surveyed, give complete legal description. If land is
unsurveyed, description should be by metes and bounds connected,
if feasible, by course and distance with a corner of public land
survey. If possible, approximate legal subdivisions of unsurveyed
lands should be stated. Acreage applied for must not exceed that
specified by regulations.
3a. Generally, title to lands will not be granted upon initial approval of
an application. In order to assure proper development or use plans,
the general practice will be to issue a lease or lease with option to
purchase after development is essentially completed. In any case,
term of lease may not exceed 20 years for non-profit organizations
or 25 years for governmental agencies, instrumentalities or political
subdivisions.
4. Leases and patents under this act are conditioned upon continuing
public enjoyment of the purposes for which the land is classified.
The plan of development, use, and maintenance must show, at a
minimum:
a. A need for proposed development by citing population trends,
shortage of facilities in area, etc.
b. That the land will benefit an existing or definitely proposed
public project authorized by proper authority.
c. Type and general location of all proposed improvements,
including public access (roads, trails, etc.). This showing may
take the form of inventory lists, maps, plats, drawings, or

(Continued page 3 )

Item
blueprints in any combination available and necessary to describe
the finished project. Site designs should be provided for intensive
use sites and general information about improvements existing or
planned on lands within the overall project.
d. An estimate of the construction costs, how the proposed project
will be financed, including a list of financial sources, and an
estimated timetable for actual construction of all improvements
and facilities.
e. A plan of management to include operating rules, proposed source
and disposition of revenues arising from the proposed operation,
personnel requirements, etc.
f. A specific maintenance plan to include, for example, sewage and
garbage disposal, road maintenance, upkeep and repair of grounds
and physical facilities, etc.
g. Applications for solid waste disposal sites must comply with
guidelines established by the Environmental Protection Agency
(40 CFR 258) and must include a detailed physical description of
the site including a map, description of ground water situation, soil
characteristics and management plan.
6. This may consist of a copy of a delegation of authority, resolution or
other evidence of authority from the governing board of the
applicant's organization, copy of the by-laws of the organization, or
the like.

(Form 2740-1, page 2)

NOTICES
The Privacy Act of 1974 and the regulation in 43 CFR 2.48 (d) require that you be furnished the following
information in connection with information required by this application.
AUTHORITY: 43 U.S.C. 869 et seq.; 43 CFR Part 2740
PRINCIPAL PURPOSE: The information is to be used to process your application.
ROUTINE USES: In accordance with the System of Records titled, “Land and Minerals Authorization Tracking
System—Interior, LLM-32,” disclosure outside the Department of the Interior may be made: (1) To appropriate
Federal agencies when concurrence or supporting information is required prior to granting or acquiring a right or
interest in lands or resources, (2) To Federal, State, or local agencies or a member of the general public in response
to a specific request for pertinent information, (3) To the U.S. Department of Justice or in a proceeding before a
court or adjudicative body when (a) the United States, the Department of the Interior, a component of the
Department, or when represented by the government, an employee of the Department is a party to litigation or
anticipated litigation or has an interest in such litigation, and (b) the Department of the Interior determines that the
disclosure is relevant or necessary to the litigation and is compatible with the purpose for which the records were
compiled, (4) To an appropriate Federal, State, local, or foreign agency responsible for investigating, prosecuting,
enforcing, or implementing a statute, regulation, rule, or order, where the disclosing agency becomes aware of an
indication of a violation or potential violation of civil or criminal law or regulation, (5) To a member of Congress or
a Congressional staff member from the record of an individual in response to an inquiry made at the request of that
individual, (6) To the Department of the Treasury to effect payment to Federal, State, and local government
agencies, nongovernmental organizations, and individuals, and (7) To individuals involved in responding to a
breach of Federal data. The BLM will only disclose this information in accordance with the Freedom of Information
Act, the Privacy Act, and the provision in 43 CFR 2.56(c).
The Paperwork Reduction Act of 1995 requires us to inform you that:
BLM collects this information to process your request for Federal lands under the provisions of June 14, 1926 (43
U.S.C. 869 as amended), Recreation and Public Purposes Act.
Information will be used to illustrate whether the applicant meets requirements of regulations found in 43 CFR
Subpart 2740.
BLM would like you to know that you do not have to respond to this or any other Federal agency-sponsored
information collection unless it displays a currently valid OMB control number.
EFFECT OF NOT PROVIDING INFORMATION: Disclosure of the information is necessary for processing of the
application. If all the information is not provided, the application may result in delay or preclude the BLM’s
acceptance of your form.
BURDEN HOURS STATEMENT: Public reporting burden for this form is estimated at 40 hours per response,
including the time for reviewing instructions, gathering, and maintaining data and completing and reviewing the
form. Direct comments regarding the burden estimate or any other aspect of this form to the U.S. Department of the
Interior, Bureau of Land Management (1004-0012), Bureau Information Collection Clearance Officer (WO-630),
1849 C Street, N.W., Mail Stop 401 LS, Washington, D.C. 20240.

(Form 2740-1, page 3)