NMS Permit Application

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NATIONAL MARINE
SANCTUARIES

NOAA NATIONAL MARINE SANCTUARIES
PERMIT APPLICATION

OMB # 0648-0141
Expires: 11/30/2027

Refer to “Instructions for Submitting Applications for National Marine Sanctuary Permits and Authorizations” for guidance
on how to properly complete this application.Applicants are responsible for reviewing the instructions in their entirety to
ensure the application meets all requirements.
Note: for certain activities, completion of this application may not be required.Consult the Office of National Marine
Sanctuaries (ONMS) permitting webpage or contact the local permit coordinator (under “Where to Apply” on the webpage)
prior to completing and submitting this application. Review the list of sanctuary prohibitions to see if your proposed project
involves an otherwise prohibited activity for a sanctuary, and would therefore require a permit.
Section A – General
Sanctuary or sanctuaries in which you are applying to work:
Gray’s Reef
Channel Islands
Greater Farallones
Cordell Bank
Hawaiian Islands Humpback Whale
NMS of American Samoa
Mallows Bay-Potomac River
Florida Keys
Monitor
Flower Garden Banks

Monterey Bay
Olympic Coast
Stellwagen Bank
Thunder Bay
Lake Ontario

Other

Enter any previously issued ONMS permit
number(s) relevant to this project or issued to the
applicant:

Select one of the following:
New application
Amendment or modification to previously issued
permit, including request for permit time extension
(Note: expired permits cannot be amended or modified)

Section B – Applicant Information
Honorific
Title

First Name

Organization address:

Last Name
Organization represented (if applicable)

Phone:

Address Line 1:

Middle Initial
Department (if applicable)

Affiliation type:
Select one

Address Line 2:
City:

Email:

State:
Zip Code:

Co-applicant (if applicable):
Honorific

First Name

Organization address:
Address Line 1:

Last Name
Phone:

State:

Affiliation type:
Select one

Address Line 2:
City:

Middle Initial

Email:

Zip Code:

Title

Organization represented (if applicable)

Department (if applicable)

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Section C – Project Information
Project title and summary (maximum 300 characters):

Project dates (mm/dd/yyyy format):
Requested permit start date:
Requested permit end date:
Project abstract (maximum 3000 characters – field will expand as needed):

Methods and protocols proposed to be employed (maximum 10000 characters – field will expand as needed). For field experiments or
monitoring, provide details on what will occur, how, when, where, and for how long. If equipment is required, fully describe and attach
supporting diagrams, as applicable. For collections, provide sampling season and frequency and justification for sample numbers. For all
projects (including lab component) provide experimental design and statistical analysis methods:

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Section C – Project Information (Continued)
Proposed location of activities:
Will this activity occur within any special
management zone (such as marine reserves, notake areas, research areas, sanctuary preservation
areas, or state preserves?

Describe specific location(s) within the sanctuary or sanctuaries where
activities are proposed to be conducted. Provide a map showing GPS
coordinates in decimal degrees for individual points, point with radius, or
polygon(s) with bounding coordinates. List any special management zone(s)
by name.

No
Yes – List zone names in box to
right and provide justification in
Section F

Section D – Collections Data
Complete this section when requesting collections as part of this activity. Collections include biological, geological and hydrological
samples. Describe the type, quantity, and size of sample to be collected. Also, describe the intended sampling location. Provide
scientific nomenclature where possible. Complete/attach additional pages if necessary. Leave blank if project does not include
collections.
Location: Identify GPS
Quantity: Identify number of Sample Limits: Identify
Type of Collection (e.g.,
coordinates in decimal
samples
per
year
or
per
maximum or minimum size,
species name, sediment type,
degrees, site name, and note if
permit
period
(if
less
than
one
or other relevant parameters.
or water sample).
in special management zone.
year).

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Section E – Environmental Effects
Answer the following questions as accurately as possible. Maximum 1000 characters per question.
Describe any direct effects on sanctuary resources or qualities that would occur at the same time and place as a result of this activity
(e.g., if equipment is used, describe level and scope of disturbance to species, habitats, or maritime heritage resources. If samples
are proposed, explain resulting effects to individuals or populations.):

Describe any indirect effects on sanctuary resources or qualities that would be caused by the action that are later in time or farther
removed in distance, or incidental to other species or habitats as result of the activity, but still reasonably foreseeable (e.g., If
equipment is used, does it have the potential to move and cause unintended effects to species, habitats, or maritime heritage
resources? Will field experiments alter the behavior of non-target species?):

Section F – Rationale
Answer the following questions as accurately as possible. Maximum 1000 characters per question.
1. Describe how the proposed activity would be conducted in a manner compatible with the National Marine Sanctuaries Act’s
primary objective to protect sanctuary resources and qualities.

2. Describe why this activity needs to be conducted within the sanctuary or sanctuaries to achieve its purpose.

3. If this activity is proposed to occur in any special management zone (e.g., marine reserves, no-take areas, research areas,
sanctuary preservation areas, NOAA regulated overflight zones, state preserves), explain why this is necessary and how it would
further the understanding of the zone.

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Section F – Rationale (Continued)
4. Describe how the proposed methods and procedures are appropriate to achieve the proposed activity’s stated purpose and would
avoid, minimize, or mitigate adverse effects on sanctuary resources and qualities as much as possible.

5. Describe how the proposed duration, seasonality, and frequency of the activity requested are appropriate for this activity and are no
greater than necessary to achieve the activity’s stated purpose.

6.

Describe how the expected end value of the proposed activity furthers sanctuary goals and purposes and outweighs any potential
adverse effects on sanctuary resources and qualities. Describe any benefits this activity has for the sanctuary or sanctuary system.

7.

Provide a statement explaining why the applicant and all personnel involved are professionally qualified to conduct and complete
the proposed activity.

8.

Provide information to demonstrate that the applicant has adequate financial resources available to conduct and complete the
the proposed activity and meet the terms and conditions of the permit.

9.

Provide information relevant to any other sanctuary-specific permit review criteria, as applicable. Enter N/A if not applicable.

Section G – Other Information
Check if the applicant or the entity represented is a small business based on the U.S. Small Business Administration's size standard.
What year is this determination based on?
Enter the U.S. Small Business Administration’s North American Industry
Classification System (NAICS) (see https://wwwsba.gov/document/
support--table-size-standards) code for your primary activity here:

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Section G – Other Information (Continued)
Identify any other permits, authorizations, or approvals obtained or required to conduct the proposed activity including, in the case of
applications for authorizations, a copy of the application for a valid lease, permit, license, approval or other authorization from any
federal, state, or local authority of competent jurisdiction.
Check here if no other federal, state, or local permits are required.
Check the boxes as appropriate if other permits or authorizations are required. Identify the status of the application(s) as not yet
submitted, in progress, or received. Provide permit number(s) and copies of any permit(s) already received.
Permit number if applicable
Marine Mammal Protection Act (MMPA) permit or authorization
Endangered Species Act (ESA) permit or authorization
U.S. Army Corps of Engineers permit
Other federal, state, or local permit(s) or authorization(s)
Check the boxes as appropriate, if consultations are required. Identify the status of the consultation(s) as not yet submitted, in
progress, or completed. Provide copies of any final assessments or analyses.

N/A
N/A
N/A
N/A
N/A
N/A

Endangered Species Act (ESA) Section 7
Coastal Zone Management Act (CZMA) Federal Consistency Determination or Negative Determination
Magnuson-Stevens Fishery Conservation Act – Essential Fish Habitat (EFH)
National Historic Preservation Act (NHPA) Section 106
Executive Order 13175 – Consultation and Coordination with Indian Tribal Governments
Other tribal, federal, state, or local consultation(s)

Check the boxes as appropriate, if to your knowledge, any of the following environmental analyses are required. Provide title of the
analysis and any associated decision document. Provide the name of agency responsible for the analysis. Identify the status of the
environmental review as not initiated, in progress, or completed.
Federal environmental impact statement, environmental assessment, or categorical exclusion memorandum prepared
pursuant to the National Environmental Policy Act (NEPA). Include the associated Record of Decision or Finding
of No Significant Impact, if the NEPA review has concluded.
State or local environmental impact statement, analysis, or review.

Section H - Certification
I certify that this application is accurate and complete. I understand incomplete applications will not be acted upon until any
required additional information is provided. I further understand that applications not received within the timelines outlined in the
instructions may not be processed in time for my activity to begin as planned. I authorize ONMS to seek peer reviews of my
proposal, if deemed necessary.
Signature of applicant:
Signature of co-applicant, if applicablblee:

Date:
Date:

(Options for authenticating this document: Provide digital signature; provide signed and scanned last page; or provide acknowledgement
using the paragraph above by email.)
Paperwork Reduction Act Statement: Notwithstanding any other provision of the law, no person is required to respond to, nor shall any
person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction
Act, unless that collection of information displays a currently valid OMB Control Number. Public reporting for this collection of
information is estimated to average 1.5 hours per response for most activities, including the time for reviewing instructions, gathering and
maintaining data, and completing and reviewing this application. See the instructions for details regarding this burden estimate.
Privacy Information: We will only use personally identifiable information submitted in this application for the purpose of considering
the permit application. We do not collect or use information for commercial marketing. We may share the information you give us with
another government agency if your inquiry relates to that agency. Please refer to the permit instructions for the Privacy Act Statement. To
view the full privacy policy, please visit https://www.osec.doc.gov/opog/privacy/NOAA-pias.html

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