ENG 6294 Right of Entry

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U.S. Army Corps of Engineers (USACE)
RIGHT OF ENTRY

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Form Approved OMB No. 0710-0003

For use of this form, see Section 404 of the Clean Water Act, Section 10 of the Rivers and Harbors Act of 1899,
and Section 103 of the Marine Protection, Research, and Sanctuaries Act, the proponent agency is CECW-COR.

Expires XX-XX-XXXX

The Agency Disclosure Notice (ADN)
The Public reporting burden for this collection of information, 0710-003, is estimated to average 5 minutes per response, including
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the
Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil.
Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to
comply with a collection of information if it does not display a currently valid OMB control number.
Purpose: This form is used by members of the public to authorize the USACE to enter their property for site investigations relating to
USACE project reviews. These reviews include onsite investigations needed to support application review, processing, and
issuance of a Clean Water Act and/or Rivers and Rivers Act delineations, determinations, and/or permits.
This form is a component in the Corps Regulatory Request System (RRS), which is an online permitting application portal for the Regulatory Program.
ITEMS 1 THRU 3 - FOR USACE USE ONLY
1. APPLICATION NO.

2. FIELD OFFICE CODE

3. DATE RECEIVED

ITEMS 4 THRU 12 - COMPLETD BY THE PROPERTY OWNER
4. PROPERTY OWNER NAME (first, middle, last)

5. PROPERTY OWNER ADDRESS:

Company:

City:

State:

E-mail Address:

Zip:

Country:

6. PROPERTY OWNER PHONE NUMBERS. w/AREA CODE
a. Residence

b. Business

c. Fax

LOCATION AND LEGAL DESCRIPTION OF PROPERTY
8. LOCATION OF PROPERTY
(in decimal degrees)

7. PROJECT STREET ADDRESS (if applicable)
Address

City:

State:

Zip:

Latitude: ◦N

Longitude: ◦W

55555555555
9. TAX PARCEL ID(s)

10. PROPERTY OWNER CERTIFICATION

By signing below, I authorize representatives of the USACE to enter upon the property described above for the purpose of conducting
on-site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act of 1899. I, the undersigned, am a duly authorized owner of record of the property identified
herein.
11. SIGNATURE OF PROPERTY OWNER

12. DATE

18 U.S.C. Section 1001 provides that: Whoever, in any manner within the jurisdiction of any department or agency of the United States knowingly and
willfully falsifies, conceals, or covers up any trick, scheme, or disguises a material fact or makes any false, fictitious or fraudulent statements or
representations or makes or uses any false writing or document knowing same to contain any false, fictitious or fraudulent statements or entry, shall be
fined not more than $10,000 or imprisoned not more than five years or both.

ENG FORM 6294, JAN 2024