PROJ00455

• Contract/PO #: C153583
• Contractor Name: Ute Water Conservancy District
• Water District: 0
• Bill Number: XB 99-999
• Loan Projects - Doc Type: Feasibility Study

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APPL'CAT'ON FOR TRANSPORTAT'ON AND UTIL'TY SYSTEMS
ANG FAC'LIT'ES ON FEGERAL LANDS

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GENERAL INFORMATION
ALASKA NATIONAL INTEREST LANDS

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This application will be used when applying for a ri~ht.of-way,
permit, license, lease, or certificate for the use of Federal lands
which lie within conservatlOn system units and National Recreation
or Conservation Areas as defined 10 the Alaska National Interest
Lands Conservation Act. Conservation system units include the
National Park System, ~ational Wildlife Refuge System, National
Wild and Scenic Rivers System. NatIOnal Trails System. National
Wilderness PreservatlOn System, and National Forest Monuments.
Transportation and utili.ty systems and facility uses for which the
application may be used are;
1. Canals, ditches, flumes, laterals, pipes, pipelines, tunnels,
and other systems for the transportation of water.
2. Pipelines and other systems for the transportation of liquids
other than water, including oil, natural gas, synthetic liquid and
gaseous fuels, and any refined product produced therefrom.
3. Pipelines, slurry and emulsion systems, and conveyor belts
for transportation of solid materials.
4. Systems for the transmission and distribution of electric
energy.
S. Systems for transmission or reception of radio, television.
telephone, telegraph, and other electronic signals, and other means
of communications.
6. Improved rights.of-way for snow machlnes, au cushion
vehicles, and all-terrain vehicles.
7. Roads, highways, railroads, tunnels, tramways. airports,
lpndin~ strips, docks, and other systems of !!:eneral transportation.

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This application must be filed simultaneously with each Federal
department or agency requiring authorization to establish an I
operate your proposal.

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In Alaska, the folloWing agencies will help the applicant file an
application and identify the other agencies the applicant should
contact and possibly file with;
Department of Agriculture
Regional Forester, Forest Service (USFS)
Federal Office Building, P,O. Box 21628
Juneau, Alaska 99802-1628
Telephone: [phone] (or a local Forest Sen'lce UI!lce)

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Deportment of Interior
Bureau of Indian Affairs (BIA)
Juneau Area Office, P.O. Box 3-8000
Juneau, Alaska 99802
Telephone: [phone]
Bureau of Land Management (BLM)
701 C Street, Box 13
Anchorage, Alaska 99513
Telephone: [phone] (or Tiocal BL.\1 Oj/lce)
National Park Service (NPS)
Alaska Regional Office, 2525 Gambell St., Rm 107
AnChorage, Alaska 99503
Telephone: [phone]
U.S. Fish & Wildlife Service (FWS)
Office of the Regional Director
lOll East Tudor Road
Anchorage, Alaska 99503
Telephone: [phone]

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Note-Filings with an}' Interior agency m~y be filed with any office
noted above or with the: Office of the Secretary of the Interior,
.Regional Er..vironmental Officer, Box 120, 1f)75 C Street, Anchor-
age, Alaska 99513.

Department of Transportation
Federal AVIation AdministratIon
Alaska Region AAL-4. P.O. 14
Anchorage, Alaska 99513

NOTE - The Department of Transportation has established the
above central filing pCHnt for agencies within that Department.
Affected agencies are: Federal Aviation Administration (F<\A),
Coast Guard (USCG). Federal Highway Ad-ninistration (FHWA),
Federal Rallroad AdmInIstration (FRA).

OTHER THAN ALASKA NA TlDNAL INTEREST LANDS

Use of this form i.s not limited to ~ational Interest Conservation
Lands of Alaska.

IndiVldual departments/ agenCIes may authorize the use of this
form by applicants for transportation and utility systems and
facilities on other Federal lands outside those areas described
above.

For proposals located outside of Alaska, applications will be Ciled
at the local agency office or at a location specified by the respon-
sible Federal agency.

SPECIFIC 'NSTRUCTIONS
({tems nol listed are self-explanatory)

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7 Attach preliminary site and facility construction plans. The
responsible agency will provide instructions whenever speci-
fic plans are required.

8 Generally, the map must show the section(s), township(s),
and range(s) within which the project is to be located. Show
the proposed location of the project on the map as accurately
as possible. Some agencies require detailed survey maps.
The responsible agency will provide additional instructions.
9, 10, and 12 - The responsible agency will provide additional
instructions.

13 Providing information on alternate routes and modes in as
much detail as possible, discussing why certain routes or
modes were rejected and why it is necessary to cross
Federal lands will assist the agency(ies) in processing your
application and reaching a final decision. Include only
reasonable alternate routes and modes as related to current
technology and economics.
14 The responsible agency will provide instructions.
15 Generally, a simple statement of the purpose of the proposal
will be sufficient. However, major proposals located in
critical or sensitive areas may require a full analysis with
additional specific information. The responsible agency
will provide additional instructions.
16 through 18 - Providing this information in as much detail as
pOSsible will assist the Federal agency(ies) in processing
the application and reaching a decision. When completing
these items, you should use sound judgment in furnishing
relevant inCormation. For example, if the project is not near
a stream or other body of water, do not address this subject.
The responsible agency will provide additional instructions.
Application mus{ be signed by the applicant or applicant's
autrcrized representative.
Public reporting burden Cor this form is estimated to vary from
30 minutes to 25 hours per response, with an average of 2 hours
per response, including the time for revieWing instructions, gather-
ing and maintaining data, and completing and reviewing the form.
Direct comments regarding the burden estimate or any other aspect
of this form to U.S. Department of the Interior, Bureau of Land
Management, (Altemate) Bureau Clearance Officer, (WO-771), 18
and C Streets, N.W., Washington, D.C. 20240, and the Office of
Information and Regulatory Affairs, Office of Management and
Budget, Washington, D.C. 20503.
If additional space is needed to complete any item, please put the
information on a separate sheet of paper and identify It as "Contin-
uation of Item".

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(For supplemental. see ret'erse)