Amendment For Forest Operations Notifications Form Page 2
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2Maine Department of Conservation Amendment for
Forest Operations Notifications
Date: ____________
Date purchased: ____________________
Notification #: _______________
Town, TWP., OR PLT__________ County: _____________________
Licensed Forester #: __________________
Designated Agent Signature: ______________________________________________Date______________
Land Owner Signature:
______________________________________________Date______________
Changes in General Information:
(Please circle whose information is
changing: Licensed Forester, Land Owner,
Designated Agent or Harvester).
Name: ___________________________________
Name: ___________________________________
Address: _________________________________
Address: _________________________________
_________________________________________
_________________________________________
Phone:___________________________________
Phone: ___________________________________
Name of nearest public or private all weather roads: ____________________________________________
Additional Harvest Information:
Is map different then original? Yes
No
if so have you included the map? Yes
No
Maine Forest Service Section
How many acres of planned harvest are included in this amendment? __________
Do you intend to clearcut? Yes
No
Any clearcuts in excess of 75 acres? Yes
No
Size in acres ______
LURC Section
Zones in which you will be harvesting if different from original FON:
Additional Land Management Road Construction:
Zones in which you will be constructing land management road if
different from original FON:
(If the proposed land management road passes through a P-WL or P-
WL2 wetland sub district, how much wetland will be altered)?
sq. ft.
________
Will you be constructing water crossings of Minor Flowing Waters?
(P-SL2 streams only). Yes
No
Have you attached necessary permits (if applicable)? Yes
No
Not Applicable
Will road be permanent or discontinued? Continued
Discontinued
If discontinued when? ___________
Specify any other activities:
(Put down anything that would be different from the original notification that is not on this amendment).
__________________________________________________________________________________________
__________________________________________________________________________________________
2009
GEO CODE _______________________(for official use only).
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