Fillable Land Classification / Designation Application (Bureau of Indian Affairs)

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Land Classification / Designation Application (Bureau of Indian Affairs)

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OMB # 1076-0141
Expires 01/31/2023
Land Classification / Designation Application
BIA-DWP-Irr-105
Rev. 01/2020
A. Applicant Information
Requester’s Name:
Select One: Landowner Bureau Official Water User Association Official
Applicable Definitions and Regulations:
Presently Assessable (PA) Definition: PA lands are categorized as those to which water can be delivered in their present state
and by virtue of their physiographic and topographic conditions, and to which water from an existing project can generally be
delivered, upon request, within a reasonable amount of time. PA lands are capable of economically producing crops under
sustained irrigation. The failure of the landowner to provide internal ditches, perform minor leveling, or remove vegetation are
not considered factors that prevent the PA designation of lands.
Temporarily Non-Assessable (TNA) Definition/Regulation: USC Title 25 Chapter 11 § 389a. TNA lands are lands that
are temporarily not suitable for production of crops by the application of water, through no fault of the landowner or water
user. “Where the Secretary finds that any such lands cannot be cultivated profitably due a present lack of water supply, proper
drainage facilities, or need of additional construction work, he shall declare such lands temporarily non-irrigable for periods
not to exceed five years and no charges shall be assessed against such lands during such periods.”
Permanently Non-Assessable (PNA) Definition/Regulation: USC Title 25 Chapter 11 § 389b. PNA lands are designated as
permanently non-irrigable lands and eliminated from the irrigation project area. “Where the Secretary finds that any such lands
are permanently non-irrigable he may, with the consent of the landowner, eliminate such lands from the project.” It is BIA policy
that changed land use is not sufficient reason to re-designate land to PNA. Any permanent changes to the land status will change
the land from irrigated to dryland status and may reduce the value of the property, diminish the resale value of the land, and
potentially impact water rights.
Requested Designation (Select One): New Change
Legal Description and Unit Serial No.:
Current Design
ation: PA Acres: TNA Acres:
Proposed
Designation: PA Acres:
PNA Acres:
PNA Acres: TNA Acres:
Describe conditions j
ustifying p
roposed designation, include Annual Assessment Waiver or Incentive Agreement
information, and deficiencies of project infrastructure (include asset ID No.). Attach additional pages if necessary:
Signature: Date of Request:
*Landowner: By signing this form I consent to PNA designation. If unit serial contains multiple landowners, I
understand their consent must be obtained prior to final approval of PNA designation.
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C-1. PNA Designation Section
B. Project Manager / Engineer: Review and Determination Section
Approve
Disapprove
Years approved for TNA (max. of 5):
Date:
Unit/Serial:
Signature:
Narrative Explanation:
Irrigation Project Processing: Attach support documentation including journal voucher, landowner notification, and
NIIMS print screens upon final approval.
Chairman Recommendation: Approve Disapprove
Signature: Date:
*Attach land designation committee report.
Agency Superintendent: Concur Non Concur
Signature: Date:
Regional Irrigation Engineer: Concur Non Concur
Signature: Date:
Regional Director -- PA and TNA Designation: Approve Disapprove
Signature: Date:
Regional Director: Concur Non Concur
Signature: Date:
Director, Bureau of Indian Affairs: Concur Non Concur
Signature: Date:
Assistant Secretary – Indian Affairs: Approve Disapprove
Signature: Date:
C. Concurrences and Approval Section
B-1. PNA Designation – Land Designation Committee Section
C-1. PNA Designation – PNA Designation Section
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INSTRUCTIONS
Section A. Applicant:
1) W
hen the applicant (requestor) is a landowner, requestor is responsible for demonstrating title or interest to th
e
p
roperty. If BIA or other official is requestor, provision of notification (or attempted notification) to th
e
l
andowner must be demonstrated. Consent of the landowner is required for proposed PNA re-designati
on.
2)
P
rovide source documents that support proposed re-designation. Examples of source documents include soi
l
surveys, rights-of-way documents, maps, and field notes.
3)
S
ubmit completed form and supporting documents to the Irrigation Project
.
S
UMMARY - Table of Determination, Recommendation, Concurrence, and Approval
From To
Determination,
Recommending Official(s)
Concurrence Approving Official
New Land PA Project Manager/ Engineer
1.
AgencySuperintendent
2.
Regional IrrigationEngineer
Regional Director
PA TNA Project Manager/ Engineer
1.
AgencySuperintendent
2.
Regional IrrigationEngineer
Regional Director
TNA or PNA PA Project Manager/ Engineer
1.
AgencySuperintendent
2.
Regional IrrigationEngineer
Regional Director
PA or TNA PNA
1.
Project Manager/Engineer
2.
Land Designation
Committee/Chair
1.
Land Owner
2.
AgencySuperintendent
3.
Regional IrrigationEngineer
4.
Regional Director
5.
Director, BIA
AS-IA
Refer to
National Irrigation Handbook, Chapter 10, Land Designation and Assessment; and Indian Affairs
Manual Part 50, Chapter 1, Irrigation for additional guidance.
Paperwork Reduction Act Notice of 1995 - This information is being collected as required under the Debt Collection
Improvement Act of 1996 (DCIA) from individuals and organizations doing business with the government. Public reporting burden
for this form is estimated to average 12 minutes per response. Direct comments regarding the burden estimate or any other aspect
of this form to the Information Collection Clearance Officer, Bureau of Indian Affairs, 1849 C Street NW, MS-4144 MIB,
Washington, DC 20240
. Note: comments, names and addresses of commentators are available for public review during regular
business hours. If you wish us to withhold this information you must state this prominently at the beginning of your comment. We
will honor your request to the extent allowable by law. A federal agency may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a currently valid OMB control number. The number and expiration date
are displayed in the upper right corner of the form.
Privacy Act Statement - The authority for requesting this information is contained in 25 U.S.C. Chapter 11, Irrigation of Allotted
Lands; 31 U.S.C. 3711, Collection and Compromise; and 25 CFR Part 171 Irrigation Operations and Maintenance. The principal
purpose for collecting this and other information is for billing and collecting O&M related costs upon assessable land designation,
and may also include proper payment application and debt management actions. Lands so designated receive all the benefits of the
project, and landowners are subject to all the responsibilities for project inclusion including repayment of O&M assessments and
construction debt. The routine use of this information is to obtain minimum information for servicing the account if you own or
lease land within an irrigation project where we assess fees and collect monies to administer, operate, maintain, and rehabilitate
project facilities (25 CFR Section 171.105). Disclosure of information may be to: U.S. Department of Justice or in a proceeding
before a court or adjudicative body; Federal, state, local, or foreign law enforcement agency; Members of Congress; Department of
Treasury to effect payment; Federal agency for collecting a debt; and other Federal agencies to detect and eliminate fraud. The
information may also be used for filing tax documents with the Internal Revenue Service (IRS) as required by law pursuant to the
routine uses identified in the National Irrigation Information Management System (NIIMS), Interior, BIA-34. Providing the
information is voluntary; however, not doing so will prevent you from participating in an Assessment Waiver, and Incentive
Agreement, a Land Classification/Designation, and/or a Payment Plan as well as making payment through Pay.gov and NIIMS. If
payment is not received, we will not deliver water; your debt will be referred to Treasury for collection actions; and your lease, if
any, may be cancelled.
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Land Classification Designation Application (Bureau of Indian Affairs)

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Completed 19 July 2020

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