FS-2700-3f Special Use Application and Temporary Permit for Outfitt

Special Use Administration

FS-2700-3f Special Use Application and Temporary Permit for Outfitting and Guiding.508

OMB: 0596-0082

Document [pdf]
Download: pdf | pdf
Use Code 153
Authorization ID: #AUTH_ID#
Contact Name: #HOLDER_ID#
Expiration Date: #EXPIRATION_DATE#

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

SPECIAL USE APPLICATION AND TEMPORARY PERMIT FOR OUTFITTING AND GUIDING
Authority: Federal Lands Recreation Enhancement Act, 16 U.S.C. 6802(h)
(Ref.: FSH 2709.11, section 41.53)

PART I – APPLICATION
1. APPLICANT INFORMATION
Applicant Name: _________________________________________________________________________

AF
T

Business Name: _________________________________________________________________________
Applicant’s Complete Address: ______________________________________________________________________
Telephone Number: (___) _______-________________
Fax number (___) _______-________________

E-mail Address______________________________

Website _________________________________________

R

As an applicant, are you (must check one):
__ Individual
If yes, are you a citizen of the United States?
__ Corporation
If yes, provide a copy of your state certificate of good standing.
__ Limited Liability Company
If yes, provide a copy of your state certificate of good standing.
__ Partnership or Association
If yes, provide a copy of your partnership or association agreement.
__ State Government or Agency
(Includes state universities)
__ Local Government or Agency
(Includes high schools)
__ Nonprofit
(Please attach a copy of your IRS Form 990)

D

Under the Regulatory Flexibility Act, a small entity is a firm that is “independently owned and operated” and “not dominant in its field of
operation.” The United States Small Business Administration has developed size standards to identify what is considered a small
business. Under these standards, a business with annual receipts of less than $6.5 million constitutes a small business for recreation
industries. Additionally, a small organization is any nonprofit enterprise that is independently owned and operated and not dominant in
its field. A small government jurisdiction is a government of a city, county, town, township, village, school district, or special district with
a population of less than 50,000.
Under these criteria, are you a small entity? _____

Page 1 of 14

2. DESCRIPTION OF PROPOSED ACTIVITY

R

A

Please include:
•
The number of service days requested (or quota equivalent).
•
The anticipated number of trips and party size.
•
Trip Itinerary with:
o Starting and ending dates of the proposed operations.
o Location of routes and starting and ending points for the proposed operations (include a map showing these
locations).
•
Services that will be offered to clients (identify any services that will be provided by a party other than the holder).
•
A description of your client base or audience.
•
A list of government facilities you propose to use, e.g., a boat launch, parking lot, or trailhead.
•
A list of temporary improvements or signs that you propose to use.
•
A statement of whether the proposed operations involve motorized equipment.
•
A statement of whether the proposed operations involve transportation livestock, and if so, whether grazing is requested.
•
A statement of whether an assigned site is requested.
•
A description of cleanup and restoration during and after the proposed operations.

D

3. ADVERTISING. Provide a current brochure and current advertising materials or website address.
4. CLIENT CHARGES. Provide a description of client charges and fees and what they cover. Attach a current rate sheet.
5. GUIDE IDENTIFICATION
•
Attach a list of all guides who would be working under the permit.
•
Describe your requirements for employment and staff training programs.
•
Attach copies of current CPR and First Aid certifications, Wilderness First Responder cards, and other applicable certifications
for guides. Please do not send copies of social security cards or passports. Send driver’s licenses only if driving is part of the
outfitting and guiding service.
•
If the state in which your activity would occur requires licensing for outfitters and guides, include a copy of relevant licenses.
6. OPERATING PLAN. Attach an operating plan that addresses client and visitor safety, evacuation and emergency procedures, and
resource protection with respect to your proposed operations and location.
____________________________________________________________________________________________________
7. LIABILITY INSURANCE. The holder will be required to obtain liability insurance in an amount satisfactory to the authorized officer
(see FSM 2713.1). The insurance policy must name the United States as an additional insured. A copy of the certificate of insurance
must be provided to the authorized officer prior to issuance of a permit.
____________________________________________________________________________________________________
8. CLIENT’S ACKNOWLEDGMENT OF RISK FORM. If you plan to use an acknowledgment of risk form, attach a copy.

Page 2 of 14

____________________________________________________________________________________________________
9. EXPERIENCE. List all permits for outfitting and guiding on National Forest System lands that you have held in the past 3 years. If
you received a performance evaluation from the Forest Service, attach a copy. If you are relying on outfitting and guiding experience
with other federal or state agencies, list any permits that you have held with those agencies in the past 3 years and provide a copy of
any performance evaluations received. List all citations or violations received in association with outfitting and guiding activities.
____________________________________________________________________________________________________
10. SIGNATURE. I hereby certify that I am of legal age and am authorized to do business in the State or Commonwealth of ____. I have
personally examined the information contained in this application and certify that this information is correct to the best of my knowledge.
I hereby acknowledge that this is an application only, and that the use and occupancy of National Forest System lands is not authorized
until a special use permit is signed and issued by an authorized officer.

Printed Name:______________________Signature: ______________________________

Date _______________

Printed Name:______________________Signature: ______________________________

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

PART II – TEMPORARY SPECIAL USE PERMIT FOR OUTFITTING AND GUIDING
Authority: Federal Lands Recreation Enhancement Act, 16 U.S.C. 6802(h)
(Ref. FSH 2709.11, section 41.53 and 37.21b)

A



R

#HOLDER_NAME# of #HOLDER_ADD_LINE_1#, #HOLDER_ADD_LINE_2#, #HOLDER_CITY#,
#HOLDER_STATE# #HOLDER_ZIP# (the holder) is hereby authorized to use, subject to the terms of this permit,
National Forest System lands described as: #TOWNSHIP_SECT_RANGE# #FIRST_DIVISION#
#FIRST_DIV_NAME_NUMBER#, #SECOND_DIVISION# #SECOND_DIV_NAME_NUMBER#, #THIRD_DIVISION#
#THIRD_DIV_NAME_NUMBER#, as shown in attached Exhibit(s) . This authorization covers approximately
#USE_ACRES# acres and/or #USE_MILES# miles.

D

This temporary use permit is issued for the purpose of authorizing the following outfitting and guiding activities on National
Forest System lands:
#PURPOSE#

_________________ temporary use service days ["or the service day equivalent of a quota"] for ___________________
[if appropriate, designate activity or district]
Selection item 1: Select to have clause appear.
The quota for this use is ["Describe the quota. For example, the quota for this use is 3 launches per day, 6 people
per launch, 2 days each week for 2 weeks"].
Selection item 2: Select to remove item 1 and have nothing appear.
__________ assigned sites for ________________________________________________
______________________ grazing use (in head months (HMs))

Page 3 of 14

The following appendices are attached to and made a part of this permit:
Appendix A – Operating Plan
Appendix B – Trip Itinerary
Appendix C – Map of the Authorized Area
Appendix D – Site-Specific Conditions
I. GENERAL TERMS AND CONDITIONS
A. AUTHORITY. This permit is issued pursuant to Federal Lands Recreation Enhancement Act, 16 U.S.C. 6802(h), and
36 CFR Part 251, Subpart B, as amended, and is subject to their provisions.
B. AUTHORIZED OFFICER. The authorized officer is the Forest Supervisor or a subordinate officer with delegated
authority.
C. TERM. This permit shall expire at midnight on #EXPIRATION_DATE#. The term for this temporary permit shall not
exceed 180 days.
D. RENEWAL AND EXTENSION. This permit is not renewable. Upon expiration of the permit all use shall return to the
temporary use pool.
E. AMENDMENT. This permit may be amended, provided that the total use authorized not exceed 200 service
days or the equivalent in quotas and the term of the permit does not exceed 180 days. Any amendments to this
permit must be in writing and must be signed and dated by the authorized officer.

A

F. COMPLIANCE WITH LAWS, REGULATIONS, AND OTHER LEGAL REQUIREMENTS. In exercising the privileges
granted by this permit, the holder shall comply with all present and future federal laws and regulations and all present and
future state, county, and municipal laws, regulations, and other legal requirements that fall under the jurisdiction of other
governmental entities.

D

R

G. NON-EXCLUSIVE USE. The use and occupancy authorized by this permit are not exclusive. The Forest
Service reserves the right of access to the permit area, including a continuing right of physical entry to the permit
area for inspection, monitoring, or any other purpose consistent with any right or obligation of the United States
under any law or regulation. The Forest Service reserves the right to allow others to use the permit area in any
way that is not inconsistent with the holder's rights and privileges under this permit, after consultation with all
parties involved. Except for any restrictions that the holder and the authorized officer agree are necessary to
protect the installation and operation of authorized temporary improvements, the lands and waters covered by this
permit shall remain open to the public for all lawful purposes.
H. ASSIGNABILITY. This permit is not assignable or transferable.
II. OPERATIONS

A. OPERATING PLAN. The operating plan submitted in the application corresponding to this permit is incorporated as
the operating plan for this permit and is attached as Appendix A. You would be required to notify the Forest Service in
writing of any staff changes during your operating season.
B. TRIP ITINERARY. The trip itinerary submitted in the application corresponding to this permit is incorporated as the
trip itinerary for this permit and is attached as Appendix B.
C. REQUIRED LICENSES. The holder shall obtain all licenses required for conducting the activities authorized by this
permit.
D. CONDITION OF OPERATIONS. The holder shall maintain the permit area to standards of repair, orderliness,
neatness, sanitation, and safety acceptable to the authorized officer and consistent with other provisions of this permit.
Page 4 of 14

Standards are subject to periodic change by the authorized officer when deemed necessary to meet statutory, regulatory,
or policy requirements or to protect National Forest System resources.
E. PROHIBITION ON USE OF MECHANIZED TRANSPORT OR MOTORIZED EQUIPMENT IN WILDERNESS AREAS.
The holder shall not use mechanized transport or motorized equipment in wilderness areas and shall not use mechanized
transport or motorized equipment in proposed or potential wilderness areas without prior written approval from the
authorized officer.
F. PROHIBITION ON IMPEDING OR INTERFERING WITH OTHER USES. The holder shall perform the activities
authorized by this permit so as not to impede or interfere with administrative or other authorized uses of National Forest
System lands.
G. RESTRICTION OF MOTOR VEHICLE USE. The holder shall restrict motor vehicle use to designated roads, trails,
and areas, unless specifically provided otherwise in the operating plan.
H. RESOURCE PROTECTION. The holder shall conduct all activities so as to prevent or minimize scarring, erosion,
littering, and pollution of National Forest System lands, water pollution, and damage to watersheds. In addition, the holder
shall take precautions at all times to prevent wildfire.
I. PERFORMANCE OF SUPPORT SERVICES. As a general rule, the holder shall conduct the day-to-day activities
authorized by this permit. Activities that support the use authorized by this permit, such as food or shuttle services, may
be conducted by a party other than the holder, but only with prior written approval from the authorized officer. The holder
shall continue to be responsible for compliance with all the terms of this permit.
J. NONDISCRIMINATION

A

1. The holder and its employees shall not discriminate against any person on the basis of race, color, sex (in
educational activities), national origin, age, or disability or by curtailing or refusing to furnish accommodations,
facilities, services, or use privileges offered to the public generally. In addition, the holder and its employees shall
comply with the provisions of Title VI of the Civil Rights Act of 1964 as amended, Section 504 of the Rehabilitation
Act of 1973, as amended, Title IX of the Education Amendments Act of 1972, as amended, and the Age
Discrimination Act of 1975, as amended.
2. The holder shall include and require compliance with the above nondiscrimination provisions in any third-party
agreement made with respect to the operations authorized under this permit.

R

3. The Forest Service shall furnish signs setting forth this policy of nondiscrimination. These signs shall be
conspicuously displayed at the public entrance to the premises and at other exterior or interior locations, as
directed by the Forest Service.

D

4. The Forest Service shall have the right to enforce the foregoing nondiscrimination provisions by suit for
specific performance or by any other available remedy under the laws of the United States or the State in which
the violation occurs.
K. EQUAL ACCESS TO FEDERAL PROGRAMS. In addition to the above nondiscrimination policy, the holder
agrees to ensure that its programs and activities are open to the general public on an equal basis and without
regard to any non-merit factor.
L. SANITATION. The operation and maintenance of all sanitation and food service systems and facilities shall
comply with applicable standards set by state and local health departments.
M. SIGNS AND TEMPORARY IMPROVEMENTS. Signs posted and temporary improvements installed on
National Forest System lands must have prior written approval from the authorized officer.

Selection item 1: Select to have clause appear.
N. NOXIOUS WEED/EXOTIC PLANT PREVENTION AND CONTROL. The holder shall be responsible for the
prevention and control of noxious weeds and/or exotic plants arising from the authorized use. For purposes of
this clause, noxious weeds and exotic plants include those species recognized as such by
______________________________________ [name of federal, state, or local authority]. The holder shall follow
prevention and control measures required by ______________________________________ [name of federal,
state, or local authority]. When determined to be necessary by the authorized officer, the holder shall develop a
Page 5 of 14

plan for noxious weed and exotic plant prevention and control. These plans must have prior written approval from
the authorized officer and, upon approval, shall be attached to this permit as an appendix.
Selection item 2: Select to remove item 1 and have nothing appear. Reletter the following clause if
necessary.

Selection item 1: Use this clause in permits involving livestock.
O. . WEED-FREE HAY. The holder shall use only hay, grain, straw, pelletized feed, or mulch certified as noxious
weed-free or noxious weed seed-free by a State Department of Agriculture or other authorized county
official. The holder shall provide documentation of that certification to the authorized officer.
Selection item 2: Select to remove item 1 and have nothing appear.
III. RIGHTS AND LIABILITIES
A. LEGAL EFFECT OF THE PERMIT. This permit, which is revocable and terminable, is not a contract or a lease, but
rather a federal license. The benefits and requirements conferred by this authorization are reviewable solely under the
procedures set forth in 36 CFR 214, and 5 U.S.C. 704. This permit does not constitute a contract for purposes of the
Contract Disputes Act, 41 U.S.C. 601. The permit is not real property, does not convey any interest in real property, and
may not be used as collateral for a loan.

A

B. THIRD-PARTY RIGHTS. This permit is subject to all valid outstanding rights. Valid outstanding rights include those
derived from mining and mineral leasing laws of the United States. The United States is not liable to the holder for the
exercise of any such right.
C. ABSENCE OF THIRD-PARTY BENEFICIARY RIGHTS. The parties to this permit do not intend to confer any
rights on any third party as a beneficiary under this permit.

D

R

D. DAMAGE TO UNITED STATES PROPERTY. The holder has an affirmative duty to protect from damage the
land, property, and other interests of the United States. Damage includes but is not limited to fire suppression
costs, damage to government-owned improvements covered by this permit, and all costs and damages
associated with or resulting from the release or threatened release of a hazardous material occurring during or as
a result of activities of the holder or the holder's heirs, assigns, agents, employees, contractors, or lessees on, or
related to, the lands, property, and other interests covered by this permit. For purposes of clauses III.D, III.F, and
II.H, "hazardous material" shall mean any hazardous substance, pollutant, contaminant, hazardous waste, oil,
and/or petroleum product, as those terms are defined under any federal, state, or local law or regulation.
E. INDEMNIFICATION OF THE UNITED STATES. The holder shall indemnify, defend, and hold harmless the United
States for any costs, damages, claims, liabilities, and judgments arising from past, present, and future acts or omissions
of the holder in connection with the use and occupancy authorized by this permit. This indemnification and hold
harmless provision includes but is not limited to acts and omissions of the holder or the holder's heirs, assigns, agents,
employees, contractors, or lessees in connection with the use and occupancy authorized by this permit which result
in: (1) violations of any laws and regulations which are now or which may in the future become applicable, and
including but not limited to those environmental laws listed in clause V.A of this permit; (2) judgments, claims, demands,
penalties, or fees assessed against the United States; (3) costs, expenses, and damages incurred by the United States;
or (4) the release or threatened release of any solid waste, hazardous waste, hazardous material, pollutant,
contaminant, oil in any form, or petroleum product into the environment. The authorized officer may prescribe terms
that allow the holder to replace, repair, restore, or otherwise undertake necessary curative actions to mitigate damages
in addition to or as an alternative to monetary indemnification.