Form 925 



(Revised March 18, 1911) 



UNITED STATES DEPARTMENT OF AGRICULTURE 



FOREST SERVICE 

 APPLICATION FOR PERMIT ON ACCOUNT OF PRIVATE LAND 



, 191. 



I, ,o 



being the owner, or lessee, of lands described as follows: 



and located within the National Forest, 



do hereby agree to allow the free and unrestricted use of the said private lands by all 

 stock permitted to graze on the adjoining National Forest lands, provided that in 



exchange for such use of the said private lands, I am permitted to graze 



(Number.) 



head of and head of upon lands 



(Kind of stock.) (Number.) (Kind of stock.) 



of the United States described as follows: . 



within the said Forest, from , to. 



(Date.) (Date.) 



during which period the said private land will adequately support the number of 

 stock above mentioned. 



I hereby bind myself and my employees engaged in caring for the animals while on 

 the Forest to extinguish all camp fires started by myself or any of my employees before 

 leaving the vicinity thereof, and to render all reasonable aid in extinguishing forest 

 fires, such service to be without compensation if required to protect the area embraced 

 in the permit, but at the prevailing rate of compensation if otherwise. 



I also hereby agree that I will allow my stock to graze only upon the areas specified 

 in the permit, and that I will obey and support all the laws and regulations governing 

 National Forests. 



I also agree that the permit shall become null and void whenever the National 

 Forest for any reason ceases to exist, or for a violation of the National Forest regula- 

 tions now or hereafter adopted or of any of the terms hereof, or whenever an injury 

 is being done to the Forest by reason of the presence of the animals therein. I also 

 agree that during the period the permit is effective I will not allow the use of the 

 above described private lands by any stock other than those permitted to graze upon 

 the adjoining National Forest lands. 



Approved , 191 . . . 



(Date of approval.) 



(Signature of applicant.) 

 (Signature of approving officer.) 



(Post-office address.) 

 " (Tltte.)" " 



89 



