Appendix 10 -4h and App G

United States Department of Agriculture

Prospectus for Campground and Related Granger-Thye Concessions

Appendix 10: FS-2700-4h, Special-Use Permit for Campground and Related Granger-Thye Concessions, and FS-2700-4h, Appendix-G, Operation of Federally Owned Drinking Water Systems

Authorization ID: #AUTH_ID#
Contact ID: #HOLDER_ID#
Use Code: #USE_CODE#
Expiration Date: #EXPIRATION_DATE#

FS-2700-4h (09/2020)

OMB No. 0596-0082

U.S. DEPARTMENT OF AGRICULTURE

FOREST SERVICE

SPECIAL USE PERMIT FOR

CAMPGROUND AND RELATED GRANGER-THYE CONCESSIONS

AUTHORITY:

Section 7 of the Granger-Thye Act, 16 U.S.C. 580d
#HOLDER_NAME#, #HOLDER_ADD_LINE_1#, #HOLDER_ADD_LINE_2#, #HOLDER_ADD_LINE_3#,

#HOLDER_CITY#, #HOLDER_STATE# #HOLDER_ZIP#

#HOLDER_NAME# (the holder) is hereby authorized to use and occupy National Forest System (NFS) lands in the

National Forest, subject to the terms of this special use permit (permit).

#PURPOSE#

FACILITY

LEGAL DESCRIPTION

ACRES

DISTRICTS

This permit covers #USE_ACRES# acres or #USE_MILES# miles, which are described above, are shown on the map attached to this permit (hereinafter the “permit area”). This permit is issued for the purpose of operating and maintaining a Forest Service developed recreation site or sites as provided herein and in the attached appendices. The following are attached to and incorporated into this permit:

<USER NOTES FOR APPENDICES>

<Add any other appendices and delete Appendix G, if inapplicable.> APPENDIX A: Annual Operating Plan
APPENDIX B: Annual Granger-Thye Fee Offset Agreement
APPENDIX C: Holder Maintenance and Reconditioning Plan
APPENDIX D: Developed Recreation Site Maps
APPENDIX E: Facility and Improvement Inventory
APPENDIX F: List of Federally Owned Improvements Covered by Property Insurance APPENDIX G: Operation of Federally Owned Drinking Water Systems APPENDIX H: Granger-Thye Fee Offset Claim

I. GENERAL TERMS

A. AUTHORITY. This permit is issued under Section 7 of the Granger-Thye Act, 16 U.S.C. 580d, and 36 CFR Part 251, Subpart B, as amended, and is subject to their provisions.

B. AUTHORIZED OFFICER. The authorized officer is the Forest or Grassland Supervisor, a District Ranger, or the Station, Institute, or Area Director with delegated authority pursuant to Forest Service Manual 2700. C. TERM. This permit shall expire at midnight on #EXPIRATION_DATE#, provided that the permit term may be extended up to 5 years by amendment at the sole discretion of the authorized officer based on sustained satisfactory performance or administrative need. Expiration of this permit shall not require notice, a decision