PERMFILE131239

• Permit No: C1981038A
• IBM Index Class Name: Permit File
• Doc Date: 12/11/2001
• Section_Exhibit Name: ENVIRONMENTAL RESOURCES - LAND USE APPENDIX
• Media Type: D
• Archive: Yes

SUPPLEMENTAL

NOTE: The responsible ^gency(ies) will Drovide additional inaWctiona. CHECK APPROPRIATE
BLOCK
! -PRIVATE CORPORATIONS wTrwCNEO PI[.EO•
a. Articles of Incorporation ^ ^
b. Corporatron Bylaws ^ ^
A ten ificalion from the State showing the corporation is in good standing and is entitled to operate within the
c' I--~ ^
State. LJ
d. Copy of resolution authorizing filing ^ ^
e. The name and address of each shareholder owning 3 percent or mox of the shares, together with the number
and percentage of any class of voting ahares of the entity which such shareholder is authorized to vole and
the name and address of each ^ftiliate o[ the entity together with, in the cane of an affiliate controlled by the ^ ^
entity, the number o[ ahares and the percentage of any tlaee o[ voting stock of that affiliate owned, directly
or indirectly, by that entity, and in the case of sn affiliate which controls that entity, the number of shsxs
and the percentage of any class of voting stock of that entity owned, directly or indirectly, by the affiliate.
f If application i^ for err oil or gas pipeline, describe any related righto(-way or temporary use permit eppll• ^ ^
cations, and identity previous applications.
g. If application is for sn oil and gas pipeline, identify all Federal lands by sgenty impacted by proposal. ^ ^
II -PUBLIC CORPORATIONS
a. Copy of law forming corporation ^
b. proof of organlzstion ^ X^
c. Copy of Bylaws ^
d. Copy of resolution authorizing filing ^
e. If application is for an oil or gas pipeline, provide information required
by Item "1-f" and "1-g" above.
^ N ~
^
iD - PARTNERSHIP OR OTHER UNINCORPORATED ENTITY
a. Articles of asaoc ialion, tf any ^ ^
b. [[ one partner rs authorized to sign, resolution authorizing action is ^ ^
c. Name and address of each participant, partner, association, or other ^ ^
d If application is for an oil or gat pipeline, provide information required
by Item "1-f" and "I-g" above. ^ ^
• If the required information is already filed with the agency processing this application and is curxnt, check block entitled "Flied."
Provide the (lie identification information (e. g., number, dare, code, name). If not on Ills or current, attach the requested information.
NOTICE EFFECT OF NOT PROVIDING INFORMATION: Disclosure of the
The Privacy Act of 1971 provides that you be furnished the information is voluntary. Hall the information is not provided, the
following irdonnation in connection with information required by applrc atron may be rejected,
this application for an authorization.
AUTHORITY: 16 U.S.C. 310; 5 U.S.C. 301.
PRINCIPLE PURPOSE: The information is to be used to process
the apptication. DATA COLLECTION STATEMENT
ROUTINE USES: (I) The procesairrg of the applicant's request The Federal agencies collect thin information from applicants
for an authoriration. (2) Documentation for public irJormation, requeatlag right-of-waY, permit, license, lease, or ceRific anon for
(3) Tnna(er to appropriate Federal agencies when tore airs race tha use of Fadenl lands.
is required prior to granting • right in publit lands or reaourcea. The Federal agent lea use this irdormallon to ev aluale the ap-
j (Q(5) Wormation from the record and/or the record will be tram- plfunl's proposd.
tarred to appropriate Federal, State, local or (orelgn agenclea,
whin relevant to civil, criminal or regulatory investigatlona or The public Is o611gated to xepond to this irformation request u
proaetut ions. they welsh to obtdn permiuion to use Federal lands.