"Forest Use Permit Application Form" - Delaware

Forest Use Permit Application Form is a legal document that was released by the Delaware Department of Agriculture - a government authority operating within Delaware.

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Download "Forest Use Permit Application Form" - Delaware

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Department of Agriculture
Forest Use Permit Application
Delaware Forest Service Web link: dda.delaware.gov/forestry
Blackbird: 302-653-6505
Dover: 302-698-4500
Redden: 302-856-2893
Date(s) of Use:
Permit No.
Application for:  Firewood
 Camping
 Other (explain)
Drivers License No.
Expiration Date
Issuing State
 Blackbird State Forest
Location
No. in Group
 Taber State Forest
 Redden State Forest
Name
First
MI
Last
Address
Street/P.O. Box
City
State
ZIP
Phone No. (
)
Phone No. (
)
Home
Work
Vehicle Information:
Year
Make/Model
Color
Tag No.
Effective Date
Expiration Date
Fee $
Comments
In exercising the above-described use, I agree to abide by all of the rules and regulations of the Department of Agriculture Forest
Service, including, but not limited to the rules which are attached to this application, as well as the instructions of the undersigned
DDA Forest Service Personnel. I fully understand that the state has neither commercially-procured insurance nor self-insurance to
cover any injury, risk or loss which occurs in the state forest and that the state is immune from any and all liability from any such
injury, risk, or loss.
In consideration of the granting of the permit, I agree to waive any and all claims arising out of the above-described use which may
accrue to myself and/or to anyone else in my custody and control, and I further agree to indemnify the state and save it harmless
from and against any and all claims, actions, damages, liability and expense in connection with loss of life, personal injury and/or
damages to property arising out of any occurrence in the state forest.
APPROVED SIGNATURE OF DDA FOREST SERVICE PERSONNEL
DATE
SIGNATURE OF APPLICANT
DATE
Note: Any violation of the state Forest rules and regulations will result in not only cancellation of this permit, but also possible arrest
and fines. This permit is to be kept in applicant’s vehicle or person and must be produced at the request of any forest offic er. This
permit is subject to cancellation by the state forester at any time for just cause. Authority Title 3, Chapter 10, Section 1008.
Department of Agriculture
Forest Use Permit Application
Delaware Forest Service Web link: dda.delaware.gov/forestry
Blackbird: 302-653-6505
Dover: 302-698-4500
Redden: 302-856-2893
Date(s) of Use:
Permit No.
Application for:  Firewood
 Camping
 Other (explain)
Drivers License No.
Expiration Date
Issuing State
 Blackbird State Forest
Location
No. in Group
 Taber State Forest
 Redden State Forest
Name
First
MI
Last
Address
Street/P.O. Box
City
State
ZIP
Phone No. (
)
Phone No. (
)
Home
Work
Vehicle Information:
Year
Make/Model
Color
Tag No.
Effective Date
Expiration Date
Fee $
Comments
In exercising the above-described use, I agree to abide by all of the rules and regulations of the Department of Agriculture Forest
Service, including, but not limited to the rules which are attached to this application, as well as the instructions of the undersigned
DDA Forest Service Personnel. I fully understand that the state has neither commercially-procured insurance nor self-insurance to
cover any injury, risk or loss which occurs in the state forest and that the state is immune from any and all liability from any such
injury, risk, or loss.
In consideration of the granting of the permit, I agree to waive any and all claims arising out of the above-described use which may
accrue to myself and/or to anyone else in my custody and control, and I further agree to indemnify the state and save it harmless
from and against any and all claims, actions, damages, liability and expense in connection with loss of life, personal injury and/or
damages to property arising out of any occurrence in the state forest.
APPROVED SIGNATURE OF DDA FOREST SERVICE PERSONNEL
DATE
SIGNATURE OF APPLICANT
DATE
Note: Any violation of the state Forest rules and regulations will result in not only cancellation of this permit, but also possible arrest
and fines. This permit is to be kept in applicant’s vehicle or person and must be produced at the request of any forest offic er. This
permit is subject to cancellation by the state forester at any time for just cause. Authority Title 3, Chapter 10, Section 1008.