Aquatic Farm Application Form - State Of Alaska
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11STATE OF ALASKA
AQUATIC FARM APPLICATION
JOINT-AGENCY AQUATIC FARM APPLICATION
FOR THE DEPARTMENTS OF NATURAL RESOURCES, FISH AND GAME,
AND ENVIRONMENTAL CONSERVATION
You may download this application from the following website:
COMPLETE THIS APPLICATION IN BLACK INK OR TYPE. SUBMIT YOUR ORIGINAL SIGNED
APPLICATION WITH THE NON-REFUNDABLE $100.00 FILING FEE (
76) TO THE
RECEIPT TYPE
DEPARTMENT OF NATURAL RESOURCES, DIVISION OF MINING, LAND AND WATER, 550 W. 7TH
AVE., SUITE 900C, ANCHORAGE, AK 99501-3577. (P
LEASE REFER TO THE APPLICATION AND GENERAL
). LABEL AND ATTACH ADDITIONAL PAGES IF NEEDED. FAXES OR XEROX
INSTRUCTIONS ATTACHED
COPIES WILL NOT BE ACCEPTED.
Note to Applicant: This is a joint-agency application form. For questions concerning the biological aspects or
operations of your proposal, please contact the Department of Fish and Game, Division of Habitat and
Restoration or the Commercial Fisheries Division, respectively. For questions concerning water quality and
sewage disposal please contact the Department of Environmental Conservation; and for questions
concerning land status and/or leasing requirements please contact the Department of Natural Resources. In
addition, this application serves as the coastal zone consistency questionnaire per the Alaska Coastal
Management Program. For questions concerning coastal consistency, please contact the Division of
Governmental Coordination. (See agency list on page 5 of the application instruction letter).
A. APPLICANT INFORMATION
Name
Contact Person, if different from applicant
Phone
Doing Business As
Mailing Address
City
State
Zip Code
Phone
Fax
E-mail address
Page 1 of 1
10/98
Revised 12/00
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