FS-2700-9a Agricultural Irrigation and Livestock Watering System Ea

Authorization ID:  #AUTH_ID#                                                                                       FS-2700-9a (09/2020)

Contact ID:  #HOLDER_ID#                                                                                            OMB No. 0596-0082

Use Code:  #USE_CODE#            

 

U.S. DEPARTMENT OF AGRICULTURE

Forest Service

AGRICULTURAL IRRIGATION AND LIVESTOCK WATERING SYSTEM EASEMENT

AUTHORITY:

#AUTHORITY_NAME#

 

THIS EASEMENT issued this day of by the UNITED STATES OF AMERICA, acting by and through the Forest Service, Department of Agriculture, hereinafter called the grantor, to #HOLDER_NAME# a of the State of hereinafter called the holder(s).

 

The Holder has applied for an easement under Section 501 of the Federal Land Policy and Management Act of October 21, 1976, as amended by P. L. 99-545 (90 Stat. 2743; 43 U.S.C. 1761), for agricultural irrigation or livestock watering system facilities located on lands owned by the United States on the National Forest, in the County(ies) of , State of .  The description of the authorized facilities is as follows:

 

Project Name: 

 

Location (legal description): 

 

                                                #TOWNSHIP_SECT_RANGE# #FIRST_DIVISION# #FIRST_DIV_NAME_NUMBER#, #SECOND_DIVISION# #SECOND_DIV_NAME_NUMBER#, #THIRD_DIVISION# #THIRD_DIV_NAME_NUMBER#   

 

User Note – “Description of Improvements”:  (e.g.headgate/diversion/collection box/ditch/pipeline/dam/reservoir; describe materials and physical dimensions of constructed facilities on NFS lands.)  Delete these instructions prior to printing.

 

Description of Improvements:  #PURPOSE#

 

Length of Easement (for linear featured facilities): 

 

Width of Easement (for linear featured facilities): 

 

Area of National Forest Lands Occupied (acres associated with either linear or non-linear features, such as reservoirs):  #USE_ACRES#

 

Upon acceptance of this easement the holder relinquishes all right, title, and interest in and to any easement issued for the same lands by the United States by any previous grant or permit.

 

The United States does hereby grant, subject to valid existing rights, an easement for occupancy with water conveyance system facilities of lands contained in Exhibit , attached hereto and incorporated herein, as provided by the holder and hereby accepted by the authorized officer.

 

This easement is issued subject to the following terms, provisions, and conditions applicable to the holder, its permittees, contractors, assignees, and successors in interest.

 

1.  Authorized Use.  This easement authorizes only the right-of-way and water conveyance system facilities as constructed and operated on October 21, 1976, as specified herein.

 

2.  Extensions or Enlargements.  This easement does not authorize extensions or enlargements of the water conveyance system.

 

3.  Fees.  This easement is issued free of charge.

 

4.  Transferability.  This easement is fully transferable provided the water conveyance system facilities are used for agricultural irrigation or livestock watering.  The holder shall notify the grantor within sixty (60) days of any address change or change in ownership.

 

5.  Tenure.   This easement shall continue for as long as the above-described lands and water conveyance system facilities are used, operated, and maintained in accordance with the terms and conditions herein described.

 

6. Operation and Maintenance.

 

a.  The holder agrees to operate and maintain the facilities and use the authorized easement in accordance with applicable Federal, State, and local laws, regulations, and standards.

 

b.  The holder shall notify, consult with, and obtain concurrence of the grantor for operation and maintenance of the authorized facilities.

 

c.  The holder agrees to install and maintain an operable headgate at each diversion structure.  Such headgate shall be capable of controlling the amount of water entering the system.

 

d.  The holder will not use fire or herbicides on the authorized right-of-way except as permitted in writing by the grantor.

 

e.  Pursuant to the requirements of 36 CFR 251.56(b)(1)(v), the terms and conditions for operation and maintenance set forth in this section, and any operations and maintenance plan incorporated in this easement pursuant to paragraph (f) of this section, may be revised or modified by the authorized officer upon determination that:

 

1.  Modification or revision of such terms and conditions is necessary to comply with the requirements of the Endangered Species Act of 1973 (16 U.S.C. 1531 et seq) or applicable State or Federal law.

 

2.  Terms and conditions contained herein are no longer needed to comply with the requirements of applicable State or Federal law.

 

USER NOTE:  ITEM “f” BELOW IS OPTIONAL.

 

Selection item 1: Select when operation and maintenance plan is attached.

 

 f.  The holder agrees to operate and maintain the facilities and use the authorized easements in accordance with the attached operation and maintenance plan.

 

Selection item 2:  Select this item to avoid having paragraph 6(f) appear in the authorization.

 

 

7.  Emergency Repairs.

 

a.  Except for emergency repairs required to protect the environment, property of the United States, or public health and safety, the holder may not use materials on National Forest System lands outside the easement prior to obtaining written authorization and paying for the materials to be used.  The holder's use of material within the easement is limited to maintenance of the water conveyance system facility.

 

b.  If the water conveyance system facilities authorized by this easement are allowed to deteriorate to the point of threatening persons or property, and the holder, after notification by the grantor, refuses to perform the repairs and maintenance required to remove the threat to persons or property, the grantor shall have the right to undertake such repair and maintenance and to assess the holder for the costs of such repair and maintenance, regardless of whether the grantor had required the holder to furnish a bond or other security.

 

8.  Indemnification. 

 

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.  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.

 

9.  Liability.  The holder shall be liable for all injury, loss, or damage, including fire suppression, or other costs in connection with rehabilitation or restoration of natural resources associated with the use and occupancy authorized by this easement.  Compensation shall include but not be 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, and all administrative, legal (including attorney's fees), and other costs in connection therewith.

 

10.  Site Restoration.  The holder shall, upon termination or revocation of this easement, stabilize the site as required by the grantor.  If the holder does not stabilize the site, the holder agrees to pay the costs of such stabilization if undertaken by the grantor.

 

The foregoing notwithstanding, this easement is granted subject to the following reservations by the grantor, for itself, its permittees, contractors, and assigns.

 

11.  Nonexclusive Use.  The grantor reserves the right to use or permit others to use the easement area, provided such use does not unreasonably interfere with the rights and privileges hereby authorized.

 

12.  Revocation and Termination.  The grantor may take action to revoke this easement pursuant to 7 CFR 1.130 through 1.151 for noncompliance with applicable statutes or regulations or the terms and conditions of this easement.  This easement also may be revoked with the consent of the holder, or if the holder fails to exercise the rights and privileges authorized for any continuous period of five (5) years or more.  This easement also terminates according to its terms if the holder uses the water conveyance system for any purpose other than agricultural irrigation or livestock watering. 

 

13.  Special Provisions.

 

USER NOTE FOR "C" CLAUSE

 

Selection item 1: Use the following clause for authorizations located within the drainages of the Colorado River when the effective date of the water right occurs after December 31, 1928.

 

 c. Colorado River Drainage.  This easement is issued subject to the Colorado River Compact and the Boulder Canyon Project Act of December 31, 1928 (45 Stat. 1057 et. seq.).

 

Selection item 2. Select this box to have nothing appear in the document when “c” is not applicable.

 

USER NOTE: 

Add additional provisions here to address local conditions.  Delete these instructions prior to printing.

 

#INSERT TERM HERE#

 

 

 

 

 

 

<Use this signature page for individual(s), partnerships, businesses, and all non-corporate entities.  Delete this instruction prior to printing.>

 

ACCEPTANCE On this ________ day of _________________, I, the undersigned Holder have read, understand, and accept the terms and conditions of this easement.

 

                                                           

 

 

ACKNOWLEDGMENT

 

 

STATE OF                                                                    )

                                                                                           ) ss.

COUNTY OF                                                                      )

 

The foregoing instrument was acknowledged before me this        day of                           ,

 

By:                                                        

 

                                                             

Notary Public

 

My commission expires:                                                

 

The Secretary of Agriculture by the , Forest Service, has executed this easement pursuant to delegations of authority specified in 7 CFR 2.60  and 36 CFR 251.52 on the day and year written above.

UNITED STATES OF AMERICA

 

 

                                                                                                             

                                                           

                                                            Region

                                                            Forest Service, Department of Agriculture

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 0596-0082.  Response to this collection of information is mandatory. The authority to collect the information is the Organic Administration Act,
16 U.S.C. 551.  The time required to complete this information collection is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

   

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs).  Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible agency or USDA’s TARGET Center at (202) 720-2600 (voice and TYY) or contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form.  To request a copy of the complaint form, call (866) 632-9992.  Submit your completed form or letter to USDA by: 
(1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]. 

USDA is an equal opportunity provider, employer, and lender.

The Privacy Act of 1974 (5 U.S.C. 552a) and the Freedom of Information Act (5 U.S.C. 552) govern the confidentiality to be provided for information received by the Forest Service.

 

 <Use this signature page for all corporate entities.  Delete instructions prior to printing.>

 

ACCEPTANCE On this              day of                                      , I, the undersigned holder have read, understand, and accept the terms and conditions of this easement.

 

 

                                                               

Holder

 

The following certificate shall be executed by the Secretary or Assistant Secretary of the Corporation:

 

I,                                       , certify that I am the Secretary of the Corporation that accepted the above easement; that                                                   ,  who signed said easement on behalf of said Corporation was then                                          of said Corporation; that I know his/her signature, and that his/her signature on said easement is genuine; and that said easement was duly signed, sealed, and attested to for and on behalf of said Corporation by authority of its governing body.

 

(CORPORATE SEAL)

                                                           

(Assistant) Secretary

 

ACKNOWLEDGMENT

 

STATE OF                                                                         )

                                                                                           ) ss.

COUNTY OF                                                                      )

 

The foregoing instrument was acknowledged before me this        day of                             ,

 

by                                                                   .

 

                                                                                                                                                                      

Notary Public

My commission expires:                                                                                                                       

 

The Secretary of Agriculture by the , Forest Service, has executed this easement pursuant to delegations of authority specified in 7 CFR 2.60 and 36 CFR 251.52 on the day and year written above.

UNITED STATES OF AMERICA

 

 

                                                                                                             

                                                           

                                                            Region

                                                            Forest Service, Department of Agriculture

 

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 0596-0082. Response to this collection of information is mandatory. The authority to collect the information is the Organic Administration Act,

16 U.S.C. 551. The time required to complete this information collection is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible agency or USDA’s TARGET Center at (202) 720-2600 (voice and TYY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

(1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected].

USDA is an equal opportunity provider, employer, and lender.

The Privacy Act of 1974 (5 U.S.C. 552a) and the Freedom of Information Act (5 U.S.C. 552) govern the confidentiality to be provided for information received by the Forest Service.

Page 13 of 13