FS-2700-3e (5/99)	
OMB No. 0596-0082	
USDA FOREST SERVICE	
SPECIAL USE APPLICATION AND PERMIT	
FOR	
GOVERNMENT-OWNED BUILDINGS	
Authority:	
The Granger-Thye Act of April 24, 1950 (16 U.S.C. 572 and 580d)	
Permission is hereby granted to:	
Holder:	     	
Address:	     	
Auto Make: 	     	License:	     	
Telephone:	     	No. of People in Group:	     	
No. of Pack or Saddlestock:	      	Snowmachines:	     	Other:	     	
Hereinafter called the holder, to use subject to the conditions set out below, the following described Government-owned	
Improvements located on the	     	National Forest:	
					
FACILITY	# DAYS	FROM	TO	INSTRUCTIONS/RESTRICTIONS	
     	     	     	     	     	
     	     	     	     	     	
     	     	     	     	     	
     	     	     	     	     	
     	     	     	     	     	
     	     	     	     	     	
Check out time is 	     	Maximum party size is 	      	
THIS PERMIT IS ACCEPTED SUBJECT TO THE CONDITIONS SET FORTH HEREIN.	
IN CONSIDERATION FOR SUCH PERMISSION, I AGREE TO ABIDE BY THE TERMS OF THIS PERMIT AND THE RULES FOR OCCUPANCY OUTLINED BY THE AUTHORIZED OFFICERS, ATTACHED TO AND MADE A PART OF THIS PERMIT.	
This permit is issued under the authority of the Granger-Thye Act of April 24, 1950.  The holder agrees to pay a fee of 	
[$	     	]	per day for a total of	[$	      	]. The Forest Service, in accordance with the Granger-Thye Act, may	
use the fees to perform necessary maintenance of the facility.	
Holder signature:	     	Date:	     	
Authorized Officer signature:	     	Date:	     	
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Terms and Conditions	
1. This permit is non-refundable.  Any changes to reserved dates must be made at least  	      	days prior to the original	
reservation.	
2. The holder shall maintain the improvements and premise to standards of repair, orderliness, neatness, sanitation, and safety acceptable to the Forest Officer in charge.  (See attached Rules for Occupancy.)	
3. The holder, in exercising the privileges granted by this permit, shall comply with the regulations of the Department of Agriculture and all Federal, State, County and municipal laws, ordinances, or regulations which are applicable to the area of operations covered by this permit.	
4. The holder shall take all reasonable precautions to prevent and suppress wildlfires.  No material shall be disposed of by burning in open fires during the closed season established by law or regulation without a written permit from the Forest Officer in charge or his authorized acting.	
5. The holder shall exercise diligence in preventing damage to the land and other property of the United States covered by, and used in connection with this permit.  The holder shall reimburse the United States for any damage of property, other than ordinary wear and tear, caused by the holder related to the occupancy of the facilities and the use of other property under the terms of this permit.	
6. Avalanches, rising water, high winds, falling limbs or trees, and other hazards are natural phenomenons in the forest that present risks which the holder assumes.  The holder assumes the responsibility of inspecting the site and immediate adjoining area for dangerous trees, hanging limbs, and other evidence of hazardous conditions and, after securing permission from the Forest Service, or removing such hazards.	
7. The holder shall pack out and properly dispose of refuse, and shall not discharge waste or refuse into surface waters.	
8. In the event of emergency rescue involving the holder or any other parties involved in the use, which require helicopter evacuation, the holder will be responsible for the cost of such rescue.	
9. No fireworks shall be stored or used on the land covered by this permit, or in the structures thereon.	
10. This permit shall not be exclusive.  The Forest Service reserves the right to use or permit others to use any part of the permitted area for any  purpose, provided such use does not interfere with the rights and privileges hereby authorized.	
11. The holder shall indemnify the United States against any liability for damage to life or property arising from the holder’s occupancy or use of National Forest lands under this permit.	
12. This permit is not transferable.	
Special Instructions/Restrictions:	

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.  The valid OMB control number for this information collection is 0596-0082.
This information is needed by the Forest Service to evaluate requests to use Naitonal Forest System lands and manage those lands to protect natural resources, administer the use, and ensue public health and safety.  This information is required to obtain or retain a benefit.  The authority for that requirement is provided by the Organic Act of 1897 and the Federal Land Policy and Management Act of 1976, which authorizes the Secretary of Agriculture to promulgate rules and regulations for authorizing and managing National Forest System lands.  These statutes, along with the Term Permit Act, National Forest Ski Area Permit Act, Granger-Thye Act, Mineral Leasing Act, Alaska Term Permit Act, Act of September 3, 1954, Wilderness Act, National Forest Roads and Trails Act, Act of Novembe4r 16, 1973, Archaeological Resources Protection Act, and the Alaska National Interest Lands Conservation Act, authorize the Secretary of Agriculture to issue authorizations for the use and occupancy of National Forest System lands.  The Secretary of Agriculture’s regulations at 36 CFR Part 251, Subpart B, establish procedures for those authorizations.
The Privacy Act of 1974 (5 U.S.C. 552a) and the Freedom of Information Act (5 U.S.C. 552) govern the confidentiality to be provided for information received by the Forest Service.  Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.	

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