Papahānaumokuākea Marine National Monument
Permit Application – Special Ocean Use
OMB Control # 0648-0548
Page
Papahānaumokuākea Marine National Monument
SPECIAL OCEAN USE Permit Application
NOTE: This Permit Application (and associated Instructions) are to propose activities to be conducted in the Papahānaumokuākea Marine National Monument. The Co-Trustees are required to determine that issuing the requested permit is compatible with the findings of Presidential Proclamation 8031. Within this Application, provide all information that you believe will assist the Co-Trustees in determining how your proposed activities are compatible with the conservation and management of the natural, historic, and cultural resources of the Papahānaumokuākea Marine National Monument (Monument).
ADDITIONAL IMPORTANT INFORMATION:
Any or all of the information within this application may be posted to the Monument website informing the public on projects proposed to occur in the Monument.
In addition to the permit application, the Applicant must either download the Monument Compliance Information Sheet from the Monument website OR request a hard copy from the Monument Permit Coordinator (contact information below). The Monument Compliance Information Sheet must be submitted to the Monument Permit Coordinator after initial application consultation.
Issuance of a Monument permit is dependent upon the completion and review of the application and Compliance Information Sheet.
INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED
Send Permit Applications to:
Papahānaumokuākea Marine National Monument Permit Coordinator
6600 Kalaniana'ole Hwy. # 300
Honolulu, HI 96825
nwhipermit@noaa.gov
PHONE: (808) 397-2660 FAX: (808) 397-2662
SUBMITTAL VIA ELECTRONIC MAIL IS PREFERRED BUT NOT REQUIRED. FOR ADDITIONAL SUBMITTAL INSTRUCTIONS, SEE THE LAST PAGE.
Papahānaumokuākea Marine National Monument
Permit Application Cover Sheet
This Permit Application Cover Sheet is intended to provide summary information and status to the public on permit applications for activities proposed to be conducted in the Papahānaumokuākea Marine National Monument. While a permit application has been received, it has not been fully reviewed nor approved by the Monument Management Board to date. The Monument permit process also ensures that all environmental reviews are conducted prior to the issuance of a Monument permit.
Summary Information
Affiliation: FORMTEXT
Permit Category: Special Ocean Use
Proposed Activity Dates: FORMTEXT
Proposed Method of Entry (Vessel/Plane): FORMTEXT
Proposed Locations: FORMTEXT
Estimated number of individuals (including Applicant) to be covered under this permit: FORMTEXT
Estimated number of days in the Monument: FORMTEXT
Description of proposed activities: (complete these sentences):
The proposed activity would…
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To accomplish this activity we would ….
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This activity would help the Monument by …
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Other information or background:
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Section A - Applicant Information
1. Applicant
Name (last, first, middle initial): FORMTEXT
Title: FORMTEXT
1a. Intended field Principal Investigator (See instructions for more information):
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2. Mailing address (street/P.O. box, city, state, country, zip): FORMTEXT
Phone: FORMTEXT
Fax: FORMTEXT
Email: FORMTEXT
For students, major professor’s name, telephone and email address: FORMTEXT
3. Affiliation (institution/agency/organization directly related to the proposed project):
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4. Additional persons to be covered by permit. List all personnel roles and names (if known at time of application) here (e.g. John Doe, Research Diver; Jane Doe, Field Technician):
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Section B: Project Information
5a. Project location(s): Ocean Based
Nihoa Island Land-based Shallow water Deep water
Necker Island (Mokumanamana) Land-based Shallow water Deep water
French Frigate Shoals Land-based Shallow water Deep water
Gardner Pinnacles Land-based Shallow water Deep water Maro Reef
Laysan Island Land-based Shallow water Deep water
Lisianski Island, Neva Shoal Land-based Shallow water Deep water
Pearl and Hermes Atoll Land-based Shallow water Deep water
Midway Atoll Land-based Shallow water Deep water
Kure Atoll Land-based Shallow water Deep water
Other
Remaining ashore on any island or atoll (with the exception of Midway & Kure Atolls and Field Camp staff on other islands/atolls) between sunset and sunrise.
NOTE: There is a fee schedule for people visiting Midway Atoll National Wildlife Refuge via vessel and aircraft.
Location Description:
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5b. Check all applicable regulated activities proposed to be conducted in the Monument:
Removing, moving, taking, harvesting, possessing, injuring, disturbing, or damaging any living or nonliving Monument resource
Drilling into, dredging, or otherwise altering the submerged lands other than by anchoring a vessel; or constructing, placing, or abandoning any structure, material, or other matter on the submerged lands
Anchoring a vessel
Deserting a vessel aground, at anchor, or adrift
Discharging or depositing any material or matter into the Monument
Touching coral, living or dead
Possessing fishing gear except when stowed and not available for immediate use during passage without interruption through the Monument
Attracting any living Monument resource
Sustenance fishing (Federal waters only, outside of Special Preservation Areas, Ecological Reserves and Special Management Areas)
Subsistence fishing (State waters only)
Swimming, snorkeling, or closed or open circuit SCUBA diving within any Special Preservation Area or Midway Atoll Special Management Area
6. Purpose/Need/Scope State purpose of proposed activities:
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*Considering the purpose of the proposed activities, do you intend to film / photograph federally protected species? Yes No
For a list of terrestrial species protected under the Endangered Species Act visit:
http://www.fws.gov/endangered/
For a list of marine species protected under the Endangered Species Act visit:
http://www.nmfs.noaa.gov/pr/species/esa/
For information about species protected under the Marine Mammal Protection Act visit:
http://www.nmfs.noaa.gov/pr/laws/mmpa/
7. Answer the Findings below by providing information that you believe will assist the Co-Trustees in determining how your proposed activities are compatible with the conservation and management of the natural, historic, and cultural resources of the Monument:
The Findings are as follows:
a. How can the activity be conducted with adequate safeguards for the cultural, natural and historic resources and ecological integrity of the Monument?
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b. How will the activity be conducted in a manner compatible with the management direction of this proclamation, considering the extent to which the conduct of the activity may diminish or enhance Monument cultural, natural and historic resources, qualities, and ecological integrity, any indirect, secondary, or cumulative effects of the activity, and the duration of such effects?
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c. Is there a practicable alternative to conducting the activity within the Monument? If not, explain why your activities must be conducted in the Monument.
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d. How does the end value of the activity outweigh its adverse impacts on Monument cultural, natural and historic resources, qualities, and ecological integrity?
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e. Explain how the duration of the activity is no longer than necessary to achieve its stated purpose.
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f. Provide information demonstrating that you are qualified to conduct and complete the activity and mitigate any potential impacts resulting from its conduct.
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g. Provide information demonstrating that you have adequate financial resources available to conduct and complete the activity and mitigate any potential impacts resulting from its conduct.
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h. Explain how your methods and procedures are appropriate to achieve the proposed activity's goals in relation to their impacts to Monument cultural, natural and historic resources, qualities, and ecological integrity.
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i. Has your vessel been outfitted with a mobile transceiver unit approved by OLE and complies with the requirements of Presidential Proclamation 8031?
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j. Demonstrate that there are no other factors that would make the issuance of a permit for the activity inappropriate.
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FOR SPECIAL OCEAN USE ACTIVITIES OUTSIDE OF MIDWAY ATOLL SPECIAL MANAGEMENT AREA, ANSWER THE ADDITIONAL THREE FINDINGS BELOW:
Explain how your activity will directly benefit the conservation and management of the Monument.
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Explain how the purpose of your activity is for research or education related to the resources or qualities of the Monument.
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Does the activity involve the use of a commercial passenger vessel (defined as a vessel that carries individuals who have paid for such carriage)?
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FOR SPECIAL OCEAN USE ACTIVITIES WITHIN MIDWAY ATOLL SPECIAL MANAGEMENT AREA, ANSWER THE ADDITIONAL TWO FINDINGS BELOW:
Explain how your activity will further the conservation and management of the Monument.
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How is your activity compatible with the purposes for which the Midway Atoll National Wildlife Refuge was designated?
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NOTE: If this is a first time Special Ocean Use activity, it will be subject to a pilot project and will be restricted in duration. Special Ocean Use activities proposed outside the Midway Atoll Special Management Area will require public notice of the application and an opportunity to provide comments is given at least 30 days prior to issuing the permit.
8. Procedures/Methods:
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9. Provide proof of general liability insurance, or indicate that you will be posting an equivalent bond against claims arising out of activities conducted under the permit:
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10. If applicable, describe how you are collaborating with others in any way to reduce duplicative activities in the Monument or elsewhere?
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11. List all specialized gear and materials to be used in this activity:
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12. List all Hazardous Materials you propose to take to and use within the Monument:
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13. Describe any fixed installations and instrumentation proposed to be set in the Monument:
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14. List all Applicants’ publications directly related to the proposed project:
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With knowledge of the penalties for false or incomplete statements, as provided by 18 U.S.C. 1001, and for perjury, as provided by 18 U.S.C. 1621, I hereby certify to the best of my abilities under penalty of perjury of that the information I have provided on this application form is true and correct. I agree that the Co-Trustees may post this application in its entirety on the Internet. I understand that the Co-Trustees will consider deleting all information that I have identified as “confidential” prior to posting the application.
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Signature Date
SEND ONE SIGNED APPLICATION VIA MAIL TO THE MONUMENT OFFICE BELOW:
Papahānaumokuākea Marine National Monument Permit Coordinator
6600 Kalaniana'ole Hwy. # 300
Honolulu, HI 96825
FAX: (808) 397-2662
DID YOU INCLUDE THESE?
Applicant CV/Resume/Biography
Intended field Principal Investigator CV/Resume/Biography
Electronic and Hard Copy of Application with Signature
Statement of information you wish to be kept confidential
Material Safety Data Sheets for Hazardous Materials
File Type | application/msword |
File Title | Northwestern Hawaiian Islands Marine National Monument |
Author | Permit Coordinator |
Last Modified By | Justin.Rivera |
File Modified | 2012-10-06 |
File Created | 2012-10-06 |