FS-2700-3b Special Use Permit for Noncommercial Group Use

Authorization ID:
Contact ID:
Expiration Date:

FS-2700-3b (XX/202X)
OMB No. 0596-0082

U.S. DEPARTMENT OF AGRICULTURE
FOREST SERVICE
SPECIAL USE PERMIT FOR
NONCOMMERCIAL GROUP USE

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:__________________________________________________________________
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:
________________________________________________________________________________________.
ESTIMATED NUMBER OF PARTICIPANTS & SPECTATORS FOR PROPOSED ACTIVITY:
Participants:
Spectators:
_________________________________________________________________________________________
___
5. STARTING & ENDING DATE & TIME OF PROPOSED ACTIVITY:
Start Date:
Time:
End 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 Phone:

( ) -

Evening Phone:

( ) -

Signature:
_____________________________________

Day Phone:

( ) -

Evening Phone:

( ) -

Signature:
_____________________________________

Date:
Date:
APPLICATION NOT VALID UNLESS SIGNED BY CONTACT
____________________________________
Signature of Contact

Date:
Page 1 of 5

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, fictitious, or fraudulent statements or representations as to any matter within its jurisdiction. Anyone who
knowingly or willfully makes or uses any false writing shall be fined not more than $10,000 or imprisoned not more than five
years, or both.

Page 2 of 5

User Note: Case File: Attach part II "Permit" to part I "Application"
PART II - PERMIT
Purpose:
Noncommercial group use permits do not grant or deny freedom of assembly or freedom of speech. The
rights to freedom of assembly and freedom of speech are guaranteed by the United States Constitution.
These rights are fully respected by the Forest Service. When noncommercial group use permits are issued,
they regulate time, place, and manner with respect to the exercise of these rights by groups of 75 or more
people on National Forest System lands. Noncommercial group use permits authorize the holder to use and
occupy the National Forest System lands covered by the permit, subject to rights retained by the United
States, including continuing rights of access, a continuing right of physical entry for inspection, monitoring, or
for any other purposes consistent with any right or obligation of the United States, and the right to require
common use of the land or to authorize use by others in any way that is not inconsistent with the privileges
granted by the permit. The use and occupancy authorized by a noncommercial group use permit would not be
allowed without the permit. The primary purposes of noncommercial group use permits include protection of
National Forest System lands and resources, promotion of public health and safety, and allocation of space
among competing uses of National Forest System lands.
Time and Date

and end on

Time and Date

A.

Use under this permit shall begin on
extended.

. The permit shall not be

B.

********************************* OR ******************(the holder) is hereby authorized to use, subject to the
terms of this permit, National Forest System lands described as Sec. **, T. ** S., R. * E., *** MERIDIAN , as
shown in attached Exhibit(s). This permit covers approximately ** acres or ___________ miles

C.

The holder is authorized to conduct the following activities and install the following improvements in the
permitted area:

D.

The holder shall conduct the authorized activities according to the attached approved plans and
specifications, Exhibit(s) ___________. The holder shall not install any improvements not specifically
identified and approved in clause C, in exhibits attached to this permit, or by the Authorized Officer during the
activity authorized by this permit.

E.

No soil, trees, or other vegetation may be destroyed or removed from National Forest System lands without
specific prior written permission from the Authorized Officer.

F.

The holder shall comply with all federal, state, county, and municipal laws, ordinances, and regulations which
are applicable to the area or operations covered by this permit.

G. The holder shall maintain the improvements and premises to standards of repair, orderliness, neatness,
sanitation, and safety acceptable to the Authorized Officer. The holder shall fully repair and bear the expense
for all damages, other than ordinary wear and tear, to National Forest System lands, roads and trails caused
by the holder's activities.
H.

The holder has the responsibility of inspecting the use area and adjoining areas for dangerous trees, hanging
limbs, and other evidence of hazardous conditions which would pose a risk of injury to individuals. After
securing permission from the Authorized Officer, the holder shall remove such hazards.

I.

The holder shall be liable for any injury, loss, or damage, including fire suppression costs and environmental
harm or injury to natural resources, that arises in connection with the use and occupancy authorized by this
permit.

J.

The holder shall indemnify and hold harmless the United States for any injury, loss, or damage, including
third-party claims, damage to federal property, fire suppression costs, and environmental harm or injury to
natural resources, that arises in connection with the use and occupancy authorized by this permit.

K.

The persons who sign this permit are not subject to any individual liability under this permit as a result of that
signature. They provide their name solely to allow notice of actions pertaining to the permit to be
communicated to the holder and to give the permit legal effect. At least one of the persons who sign this
Page 3 of 5

permit shall be available to the Forest Service from the date this permit is issued until the use authorized by
this permit has concluded.
L.

The holder agrees to permit free and unrestricted access to and upon the premises at all times for all lawful
and proper purposes not inconsistent with the intent of the permit or with the reasonable exercise and
enjoyment by the holder of the privileges thereof.

M. This permit is subject to all valid existing rights and claims outstanding in third parties.
N.

This authorization may be revoked or suspended only in accordance with 36 CFR 251.60(a)(1)(i). Upon
expiration or revocation of this permit, the holder shall immediately remove all improvements except those
owned by the United States and shall restore the site within____________ days, unless otherwise agreed
upon in writing. If the holder fails to remove the improvements, they shall become the property of the United
States, but that will not relieve the holder of liability for the cost of their removal and the restoration of the site.

O. This permit is a license for the use of federally owned land. It does not grant any interest in real property. This
permit is not transferable. The holder shall not enter into any agreements with third parties for occupancy of
the authorized premises and improvements.
P.

Any decision concerning this permit, including but not limited to suspension or revocation and modification of
permit terms and conditions, is not subject to administrative appeal and is immediately subject to judicial
review.

Q. This permit is accepted subject to the conditions set forth herein, including any conditions in any exhibits
attached to and made a part of this permit.
R.

This permit, and any appendices incorporated into this permit by reference, constitute the complete
understanding of the parties to this permit as to the rights, duties, and obligations of each party as of the date
of issuance of this permit. If there are any inconsistencies between aby of the preceding clauses and any
subsequent clauses or any appendices to this permit, the preceding clauses shall govern.

I have read and understand the terms and conditions
and agree to abide by them.

U.S. DEPARTMENT OF AGRICULTURE
Forest Service

HOLDER:

Authorization is granted:

By: __________________________________________
(Holder Signature)

By: __________________________________________
(Authorized Officer Signature)

Name: ________________________________________

Name: ________________________________________

Date: ________________________________________

Title: ________________________________________

Date: ________________________________________
PAPERWORK REDUCTION ACT STATEMENT
According to the Paperwork Reduction Act of 1995, a Federal agency may not conduct or sponsor, and a person is not required to respond
to, an information collection request unless it displays a valid Office of Management and Budget (OMB) control number. The valid OMB
control number for this information collection request is 0596-0082. Response to this information collection request is required to obtain or
retain benefits, specifically, a special use authorization. The authority for this information collection request is Organic Administration Act, 16
U.S.C. 551. The time required to complete this information collection request is estimated to average 15 minutes per response, including the
time for reviewing instructions, searching existing data sources, collecting and maintaining the data needed, and completing and reviewing
the information collection request. Send comments regarding this burden estimate or any other aspect of this information collection request,
including suggestions for reducing the burden, to Forest Service Information Collections Officer, SM.FS.InfoCollect@usda.gov, with OMB
control number 0596-0082 in the subject line.
Page 4 of 5

PRIVACY ACT STATEMENT
Pursuant to 5 U.S.C. § 552a(e)(3), this Privacy Act statement serves to inform you of the following concerning the collection of the information
on this form.
Purpose: The Privacy Act of 1974 requires that the Director of Recreation, Heritage, and Volunteer Resources staff and the Director of
Lands, Minerals, and Geology Management staff provide the following statements to individuals from whom they request information.
Authority: Collection of this information solicited on this form is authorized by Organic Administration Act, 16 U.S.C. 551.
Routine Uses: The information collected will be used by Forest Service officials to ensure that your use of National Forest System lands is
administered in accordance with applicable statutes, regulations, and directives. The information collected from you is retained in the Special
Uses Data System (SUDS) and is retrieved by the Forest Service create reports for the Agency’s Special Uses Program, generate bills for
collection of land use fees for your authorization, monitor compliance with your special use authorization, and other matters pertaining to
administration of your special use authorization. SUDS is a component of the Forest Service’s Natural Resources Manager database (NRM).
A complete list of the routine uses of NRM can be found in the system of records notice associated with this form, FS-24.
Disclosure: The submission of this information is required to obtain or retain benefits, specifically, a special use authorization.
NONDISCRIMINATION STATEMENT
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, 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 State or local Agency that administers the program or contact USDA through the
Telecommunications Relay Service at 711 (voice and TTY). 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 the
information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit the 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: program.intake@usda.gov.
USDA is an equal opportunity provider, employer, and lender.

Page 5 of 5