DNR Form 542-1240 "Application Fee Invoice for Open Feedlots and Designated Confinement Feeding Operations" - Iowa

What Is DNR Form 542-1240?

This is a legal form that was released by the Iowa Department of Natural Resources - a government authority operating within Iowa. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2014;
  • The latest edition provided by the Iowa Department of Natural Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of DNR Form 542-1240 by clicking the link below or browse more documents and templates provided by the Iowa Department of Natural Resources.

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Download DNR Form 542-1240 "Application Fee Invoice for Open Feedlots and Designated Confinement Feeding Operations" - Iowa

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CASHIER’S USE ONLY
National Pollutant Discharge Elimination System (NPDES)
0945-542-NPDE-PM-0570
Application Fee Invoice
32-3201
For Open Feedlots and Designated Confinement Feeding Operations
Permit ID #
Facility Name
Facility Name:
Contact Name:
Address:
City, State, Zip:
Fee amount due: $85
For Staff Use Only
Fee due date:
Permit ID #:
This application is for animal feedlot operations that are applying for a National Pollutant Discharge Elimination System
(NPDES) permit. An $85 application fee is due whenever a NPDES permit application (DNR Form 542-4001) is submitted
to the Department of Natural Resources (DNR).
Failure to provide all the required application materials or appropriate fees may result in revocation or suspension of the
facility's NPDES permit as noted in Iowa Administrative Code 567-64.3(11)"f." Be advised that a discharge of a pollutant
without a permit is a violation of Iowa Administrative Code 567-62.1(1).
Please sign and return this form together with a check or money order made payable to the "Iowa Department of
Natural Resources" or the “Iowa DNR.” If you have any questions regarding the application fee, please contact Reza
Khosravi at
reza.khosravi@dnr.iowa.gov
or 515-725-8408.
Signature of Responsible Official:
Printed Name:
Title:
Mail to:
Iowa Department of Natural Resources
th
502 East 9
Street
Des Moines, IA 50319-0034
11/2014 cmc
DNR Form 542-1240
CASHIER’S USE ONLY
National Pollutant Discharge Elimination System (NPDES)
0945-542-NPDE-PM-0570
Application Fee Invoice
32-3201
For Open Feedlots and Designated Confinement Feeding Operations
Permit ID #
Facility Name
Facility Name:
Contact Name:
Address:
City, State, Zip:
Fee amount due: $85
For Staff Use Only
Fee due date:
Permit ID #:
This application is for animal feedlot operations that are applying for a National Pollutant Discharge Elimination System
(NPDES) permit. An $85 application fee is due whenever a NPDES permit application (DNR Form 542-4001) is submitted
to the Department of Natural Resources (DNR).
Failure to provide all the required application materials or appropriate fees may result in revocation or suspension of the
facility's NPDES permit as noted in Iowa Administrative Code 567-64.3(11)"f." Be advised that a discharge of a pollutant
without a permit is a violation of Iowa Administrative Code 567-62.1(1).
Please sign and return this form together with a check or money order made payable to the "Iowa Department of
Natural Resources" or the “Iowa DNR.” If you have any questions regarding the application fee, please contact Reza
Khosravi at
reza.khosravi@dnr.iowa.gov
or 515-725-8408.
Signature of Responsible Official:
Printed Name:
Title:
Mail to:
Iowa Department of Natural Resources
th
502 East 9
Street
Des Moines, IA 50319-0034
11/2014 cmc
DNR Form 542-1240