Land Use Permit Request Form

Directions: Please fill out the necessary Land Use Permit Request Form to request entry into Eyak Corporation lands. A Eyak Corporation representative will contact you after submission and will either grant or not grant you access to the land in question.

Applicant Information:

Full Name:(*)
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Address:(*)
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Phone:(*)
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Email:(*)
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Hereinafter called the "PERMITTEE" to enter upon certain lands held by THE EYAK CORPORATION, for the PURPOSE of:

(*)
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(if you chose "Other", please fill out what the purpose is for - otherwise leave blank.)
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Eyak reserves the exclusive right to grant additional permits, easements for rights-of-way or other uses to third parties for any uses on, or adjacent to, the land subject to this permit.

1. TERM: The term of this permit shall be for a period not to exceed "X" number of days , unless otherwise revoked or amended in writing by Eyak. If no other time period is stated, this permit expires (365 days) one year from the date of issuance. This permit is revocable in the sole discretion of Eyak at any time, if Permittee fails to comply with any term or regulation contained in this permit. This permit shall be deemed to be canceled.

2. CONSIDERATION: The Permittee agrees they may need to pay a fee of $_______ depending on what activities they may be doing to help Eyak cover land management administration costs. The permittee agrees this fee is not compensation for the use or the occupancy of the lands.

3. PERMITTED ACTIVITIES: The Permittee shall conduct only those activities on the lands subject to this permit in accordance with the aforementioned purpose. The Permittee shall conduct all activities in such a manner to ensure the least practicable temporary and permanent harm to the lands subject to this permit. Permittee shall take all reasonable precautions to prevent and suppress forest; brush and grass fire, and prevent the pollution of waters on or in the vicinity of the lands. Permittee's uses of Eyak lands shall be consistent with and subject to the policies applicable to this Permit stated in the "Non-Commercial Public Access land/Natural Resource Use Permit Program" , which is incorporated into this Permit by reference as if set forth in full herein.

* Firewood Cutting is permitted only at fallen log deck sites. The cutting of live trees is prohibited.

4. PROHIBITED ACTIVITIES: Permittee shall not disturb, cut, remove, or displace any materials on Eyak lands not specifically allowed by this permit, nor shall the Permittee operate any vehicles or equipment outside of the approved permit boundaries, without first obtaining prior written authorization from Eyak to do so. "Materials" includes, but is not limited to gravel, rock, sand, peat, timber and all other vegetative materials. No firearms shall be discharged on or near Eyak lands unless serious Health risk-emergency situations shall occur or the use of firearms has been specifically permitted by Eyak.

5. REFUSE AND HAZARDOUS WASTE DISPOSAL: The Permittee shall keep the premises in a neat, orderly, safe and sanitary condition and shall remove all human waste, refuse, bottles, cans and burnable materials generated from the use of the above referenced land to approved disposal areas and shall not bring onto or dispose on the premises any hazardous waste or materials.

6. CEMETERY AND HISTORICAL SITES: No land beyond that which is absolutely necessary for the activities authorized herein shall be disturbed by the Permittee. Any cemetery or historical sites or artifacts discovered by Permittee shall be left in place and reported as soon as possible to Eyak.

7. LIABILITY FOR DAMAGE TO LAND: Any structure, property or land harmed or damaged by the Permittee shall be reconstructed, repaired, rehabilitated, and restored as may be required by Eyak, by Permittee as soon as practicable, so that the condition thereof, at the sole discretion of Eyak, is at least equal to the condition thereof immediately prior to such damage or destruction. Permittee shall immediately cease and/or eliminate any condition existing or occurring which may cause harm or damage to any person, structure, property, land stream or wildlife. Permittee shall protect all survey monuments, witness corners, reference monuments, mining claims posts and bearing trees against damage, destruction or obliteration. Any damage or obliterated marker shall be re-established by the Permittee in accordance with accepted survey practices of the State. The permittee shall pay all costs resulting from violation of any term of this permit.

8. INDEMNIFICATION/HOLD HARMLESS: The Permittee shall have the duty to defend and indemnify Eyak and hold it harmless against all liability, with no limit, for any and all claims, demands, suits, damages, costs, losses and expenses, including legal costs, and for any and all injury to or death of persons and damage to or loss of property, resulting or arising out of, or in any way connected with , the use or occupation of Eyak lands by Permittee or the failure of Permittee to perform fully any and all of these stipulations. Permittee shall be responsible for any problems that may arise in the future that result from Permittee's actions.

9. TRANSFER/ASSIGNMENT: The Permittee shall not transfer or assign this permit without the express prior written consent of Eyak.

10. LAW AND REGULATIONS: The Permittee shall be responsible for and comply with all applicable federal, state and local laws and regulations pertaining to the lands subject to this permit and its activities thereon.

The Permittee certifies the he/she has read and is familiar with the Eyak Land Use Regulations and that all operations shall be performed in strict compliance with said regulations and any Special Conditions specified by Eyak in issuing this permit.

Prohibited Area: Mile Post 43-46 Copper River Highway.

To acknowledge everything you have read and agreed upon, please sign your full name in the box below.

PERMITEE:(*)
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Type Signature in here