+------------+---------------------------------------+-----------------+
| Form       | UNITED STATES DEPARTMENT OF THE       | INFORMATION     |
| 8151-1     | INTERIOR                              | REQUIREMENT     |
| (          |                                       |                 |
| temporary) | BUREAU OF LAND MANAGEMENT             | APPROVED        |
|            |                                       |                 |
| (May 1984) | CULTURAL RESOURCE USE PERMIT          | OMB No.         |
|            |                                       | 1024-0037       |
| Attach     | Sec. 302(b) of P.L. 94-570, October   |                 |
| separate   | 21, 1976, 43 U.S.C. 1732 and sec. 4   |                 |
| sheets as  | of P.L. 96-95, October 31, 1979, 16   |                 |
| needed for | U.S.C. 470cc                          |                 |
| additional |                                       |                 |
| space      | **APPLICATION**                       |                 |
+------------+---------------------------------------+-----------------+
|            |                                       | FOR BLM USE     |
|            |                                       | ONLY            |
|            |                                       |                 |
|            |                                       | Application     |
|            |                                       | Number          |
+------------+---------------------------------------+-----------------+
|            |                                       |                 |
+------------+---------------------------------------+-----------------+

1\. Name of Applicant (Institution, Corporation, Partnership,
Individual, or Other Entity)

+--------------------------------------------------+-------------------+
| 2\. Mailing Address                              | 3\. Telephone     |
|                                                  | Number            |
|                                                  |                   |
|                                                  | Fax:              |
+--------------------------------------------------+-------------------+

+-----------------------------------+-----------------------------------+
| 4\. Nature of Cultural Resource   | 5\. Location of Proposed Work     |
| Work Proposed                     |                                   |
|                                   | a\. Description of Public Lands   |
| > \| \| Non-Collection            | Involved                          |
| > Survey/Recordation              |                                   |
|                                   | B. Identification of Cultural     |
| \| \| Survey and Limited Testing  | Resource(s) Involved (if          |
|                                   | applicable)                       |
| \| \| Excavation and/or Removal   |                                   |
+-----------------------------------+-----------------------------------+
| 6\. Purpose of Proposed Work      | 7\. Time of Proposed Work         |
|                                   |                                   |
|                                   | From To                           |
+-----------------------------------+-----------------------------------+

8\. Name of individual(s) Authorized to Plan and Supervise Field Work
and Approve Reports,

Evaluations, and Recommendations

Principal Investigator(s):

Crew Chief(s):

9\. Applicant must include the following with the application form:

> a\. Summary of organizational capabilities, including information on
> location(s) and description of facilities and equipment, on
> organization structure and staffing, and on facilities, equipment, and
> staff to be involved in the proposed work;
>
> b\. Summary of organizational history in completing work of the kind
> proposed, including similar past projects, government contracts, and
> Federal permits (previously held, currently in force with effective
> dates, and currently pending or planned, by agency and region/state),
> reports and publications resulting from similar work, and any other
> pertinent organizational experience;

c\. For each individual named as responsible for technical tasks, a
curriculum vitae or other rèsume or summary of education, training, and
experience in the kind of work proposed and in the role proposed;

d\. Written certification, signed by a properly authorized official of
the proposed curatorial facility, attesting to the facility's capability
and willingness to accept any collections, as applicable, and records,
data, photographs, and other documents generated during the proposed
term of the permit, and to assume permanent curatorial responsibility
for such materials on behalf of the United States Government.

10\. Name of Individual Responsible for Carrying Out Terms and
Conditions of Permit

  ----------------------------------- -----------------------------------
  11\. Signature                      12\. Date

  ----------------------------------- -----------------------------------

Submit one complete copy of each application, by mail or in person,

to the State Director (930) in the BLM State Office with

administrative jurisdiction over the public lands involved.