Special Land Use Permit

Special Use Permit & License Application

First Name:

REQUIRED

Last Name:

REQUIRED

Organization:

Address 1:

REQUIRED

Address 2:

Town:

REQUIRED

State:

REQUIRED

Zip:

REQUIRED

Email:

REQUIRED

Re-Enter Email:

REQUIRED

Phone:

REQUIRED

Have you applied for a license with FPR in the Past?

Yes

Please describe the activity or activities that you are requesting the license for:

Activity County:

REQUIRED

Activity Locations:

REQUIRED

Please note the size of your group and any special requirements that this activity requires (parking, sanitary facilities, traffic control, special signing, medical services):

Please select all start and end dates of the events

Start Date

End Date

Click item to remove date from list

Will any items be sold?

Yes

REQUIRED

If yes, list items and prices

Will a fee be charged?

Yes

REQUIRED

If Yes, you must enclose documentation of your per-day client charge, registration fees, etc. by either writing below, or enclosing appropriate advertising materials, brochures, or a signed letter stating what the fees to be charged are and for what purposes. Be sure to explain how much of the fee, if any, is paid to others for long-distance transportation and lodging, and provide documentation of this.

Attach documents to the application by browsing to the document and clicking the [Attach] button.

[Attach]