DI Form 9003 (Rev. 02/2022) OMB Control No. 1093-0008
U.S. Department of the Interior Expires XX/XX/20XX
Paleontology Permit
This permit documents the Federal land manager’s approval of an application. Bureaus may also issue accompanying memoranda and/or other permits. A copy of this permit must be carried whenever work is in progress, kept with paleontological resources during transport, and shared with the approved repository.
Permit Number (all correspondence between the bureau and permittee should reference this permit number)
|
|
1a. Permittee Name
|
1b. Permittee Institutional Affiliation |
2. Professional Contact Information
|
3. Field Contact Information |
4. Location of Authorized Work
|
|
5. Description of Authorized Work
|
|
6. Dates of Authorized Work (A Notice to Proceed may be required prior to the start of fieldwork)
Start: End: |
|
7. Individuals who will be Responsible for Supervising or Conducting Work
|
|
8. Name, Location, and Contact Information of the Approved Repository
|
|
9. Terms and Conditions
|
|
10. Upon the execution of this permit, the permittee acknowledges and accepts all of the attached terms and conditions
Signature and Title of Permittee Date |
|
Signature and Title of Federal Land Manager Date |
Page
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Nagode, Jill K |
File Modified | 0000-00-00 |
File Created | 2022-10-06 |