Application Form - Alaska'S Aquatic Farm Program - Department Of Natural Resources Page 3
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21For Office Use Only
ADNR File No:
ADF&G No:
ADNR/DCOM No:
DATE STAMP:
2011 AQUATIC FARM PROGRAM APPLICATION
You are encouraged to submit a completed application as early in the filing period as possible. The 2011
application form must be used and properly completed before state agencies can process your project. An
incomplete application will not be processed. A checklist is included on page ii of this application to assist you
in meeting this requirement. The best way to facilitate the review of your application is to schedule a pre-
application meeting with DNR and ADF&G to discuss your project. The original application including
attachments and all required fees must be delivered and physically present in the Alaska Department of Natural
Resources office listed on page i, by 5:00 p.m., Monday, May 2, 2011.
The project is proposed in: (Check one)
Southeast Alaska
Southcentral Alaska
NOTE: Southeast = Projects south of or in the Yakutat area / Southcentral = Projects north of Yakutat
________________________________________________________________ __________________
A. APPLICANT INFORMATION
If you live in a remote area please provide a contact person
(name, phone & email address) who can be easily reached.
_____________________________________________
Name
______________________________________________
Contact Name
___________________________________________________
Business Name (If Applicable)
______________________________________________
Contact Phone Number
______________________________________________
______________________________________________
Mailing Address (PO Box or Street Address)
Contact Email Address
______________________________________________
______________________________________________
City
State
Zip
Business Partner Name (If applicable)
______________________________________________
______________________________________________
Email Address
Business Partner Phone Number (If applicable)
Phone
Cell Phone
________________________________________________________________ __________________
B. PROJECT DESCRIPTION
On a separate piece of paper, please provide a general description of your proposed aquatic farm site and
operations. This should be a narrative of your proposal that includes where your project will be located, overall
size including any hardening area, all species you intend to culture, proposed farm gear, equipment, support
facilities, and associated housing. Include the size, number, type, and construction materials of all gear,
equipment, and support facilities you want to use in your operations. Your narrative should match the
information you provide throughout the rest of the application. It will be used by state and federal agencies and
the public for comment and review. Be sure to label your narrative, “PROJECT DESCRIPTION”.
Aquatic Farm Program
You may download this application,
Instructions/Application - Part II
from the following website:
Revised December 2010
Page 1 of 19
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