Form Fs 7700 40 – Fill Out and Use This PDF

USDA Forest Service	FS-7700-40 (Rev 11/2006)
	OMB 0596-0016 (Expires 11/2009)
	APPLICATION FOR PERMIT
	NON-FEDERAL COMMERCIAL USE OF ROADS RESTRICTED BY ORDER
	(FSM 7732)

NOTE: This report is authorized by Acts of June 10, 1914; April 24, 1950; June 12, 1960, and October 13, 1964 (USC 478,572,530 and 532-38). No permit may be issued unless a completed Form 7700-40 is received.

				For Official Use Only			DATE OF APPLICATION
REGION			STATE	COUNTY	FOREST	RANGER DISTRICT
1. APPLICANT (Name, address, and Zip Code)						TELEPHONE NUMBER
						(		)	-

2. DESCRIPTION AND MILEAGE OF ROAD(S) OR ROAD SEGMENT(S) TO BE USED (as shown on attached map)

3. PURPOSE OF USE

HAULING LOGS OR LUMBER				MBF
(Quantity)
HAULING OTHER MATERIALS				TONS
	(Quantity)

DESCRIBE MATERIALS

4. USE SCHEDULE
	SEASON	NUMBER OF DAYS OF USE			TYPE OF TRUCKS TO BE			TYPE OF LOADING TO BE
						USED			USED

5.PLANS FOR FUTURE USE (Not applied for on this application)

	HAULING LOGS OR LUMBER									MBF
					(Estimated Quantity)
	HAULING OTHER MATERIALS									TONS
					(Estimated Quantity)
DESCRIBE MATERIALS
ESTIMATED PERIOD OF USE FROM				TO

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USDA Forest Service	FS-7700-40 (Rev 11/2006)
	OMB 0596-0016 (Expires 11/2009)

REPORT ON APPLICATION

(To Be Completed By District Ranger)

1.GENERAL DESCRIPTION AND ADAPTABILITY OF ROAD(S) FOR PROPOSED USE. (Show road(s) on 1/2" Forest Transportation Map)

2.IMPROVEMENTS FOR BETTERMENT WORK NEEDED ON ROAD(S) TO SAFELY ACCOMMODATE THE ADDITIONAL TRAFFIC

3.IMPROVEMENTS OR BETTERMENT WORK DESIRED

4.RECOMMENDATION OR COMMENTS (Include any factors which might affect the granting of the hauling permit or future use of the road(s).)

REPORT SUBMITTED					NAME AND SIGNATURE		TITLE			DATE
REPORT APPROVED					NAME AND SIGNATURE		TITLE			DATE

Burden and Privacy Act Statements

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0596-0016. The time required to complete this information collection 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.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at 202-720-2600 (voice and TDD).

To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

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.

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