Fillable Stelprdb5328801 (USDA Forest Service)

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Stelprdb5328801 (USDA Forest Service)

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Auth ID: #AUTH_ID#
FS-2700-3b (03/06)
Contact ID: #HOLDER_ID#
OMB No. 0596-0082
Expiration Date: #EXPIRATION_DATE#
U.S. DEPARTMENT OF AGRICULTURE
Forest Service
SPECIAL-USE PERMIT FOR
NONCOMMERCIAL GROUP USE
(Ref.: 36 CFR 251.54)
Authority: Organic Act of 1897,16 U.S.C. 551
PART I - APPLICATION
1. APPLICANT INFORMATION:
Name of Group or Event:
Address of Group or
Contact: (whichever is applicable)
Name of Contact:
The contact shall be available to the Forest Service from the date this application is signed until it is accepted, rejected, or
denied.
Day Phone: ( ) - Evening Phone: ( ) -
2. DESCRIPTION OF PROPOSED ACTIVITY:
3.
LOCATION & DESCRIPTION OF NATIONAL FOREST SYSTEM LANDS & FACILITIES APPLICANT WOULD LIKE TO USE:
4. ESTIMATED NUMBER OF PARTICIPANTS & SPECTATORS FOR PROPOSED ACTIVITY:
Participants:
Spectators:
5. STARTING & ENDING DATE & TIME OF PROPOSED ACTIVITY:
Start
End:
Date
Time
Date
Time
6. NAME OF PERSONS WHO WILL SIGN A SPECIAL USE PERMIT ON BEHALF OF THE GROUP (May be same
as contact listed in item 1.):
Name:
Name:
Address:
Address:
)
-
/ (
)
-
Day & Evening Phone: (
Day & Evening Phone: (
)
-
/ (
)
-
Signature:
Signature:
Date:
Date:
APPLICATION NOT VALID UNLESS SIGNED BY CONTACT
Signature of Contact
Date
18 U.S.C. § 1001 makes it a crime for any person knowingly and willfully to make to any department or agency of the United States any false,
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Stelprdb5328801 (USDA Forest Service)

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Completed 18 July 2020

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