Form 8151-3 - Fieldwork Authorization Request
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1Form 8151-3
United States
INFORMATION
Department of the Interior
REQUIREMENT
Bureau of Land Management
APPROVED
OMB NO. 1024-0037
FIELDWORK AUTHORIZATION REQUEST
For BLM Use Only
To Conduct Specific Cultural Resource Work under the Authority of a
Cultural Resource Use Permit Issued by the Bureau of Land Management
Pursuant to Sec. 302 (b) of P. L. 94-579, October 21, 1976, 43 USC 1732
Sec. 4 of P. L. 96-95, October 31, 1979, 16 USC, 470cc
1. Permit Number and Date Issued
2. Name of Permittee
3. Mailing Address and Telephone Number
Address:
4. Nature of Cultural Resources Work Proposed (if Consultation Work, Identify Client and Project)
5. Location of Proposed Work (Include Map)
a. Description of Public Lands Involved
b. Identification of Cultural Resource(s) Involved (if applicable)
6. Period During Which Work Will Be Conducted
From
:
To
:
7. Name of Individual(s) Responsible for Planning and Supervising Fieldwork and Approving Report, Evaluations, and Recommendations
8. Signature
9. Date
10. Approved
11. Date
(Authorized Officer)
Submit one copy of each request, by mail, FAX, or in person to the Field Office Manager in the BLM
Field Office with administrative jurisdiction over the public lands involved.
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