NATIONAL FOREST MANUAL. 27 



for months, covering certain lands of 



the United States within the National 



Forest in the State of , as such lands 



are approximately shown upon a certain map executed by 



, on the day of , 191__, which map is 



filed herewith and made a part hereof. This application is made in order 

 that may, upon the filing of a com- 

 plete and final application in accordance with the regulations of the Secretary 

 of Agriculture, secure a priority for said final application from the date of the 

 filing of this preliminary application. 



(Space for insertion of request for construction work if necessary to maintain water 



rights.) 



In witness whereof ha__caused 



this instrument to be executed this day of , 191__. 



(Seal of corporation.) 

 Attest : 



Secretary. 



Subscribed and sworn to before me this day -of , 191__. 



(Seal.) , 



Notary Public. 



(Copies of this form may be obtained by application to the district foresters.) 



Form 58a. (Revised to Mar. 1, 1913.) 



UNITED STATES DEPARTMENT OF AGRICULTURE. 



FOREST SERVICE. 

 Certification of receipt of application for power permit or right-of-way grant. 



The within application of for a 



under the act of was first received by me 



at on , 191__, having been found incomplete it was 



returned to the applicant and was again received on The date of 



priority is 



District Forester. 



The within application having been found incomplete when filed on 



was returned to the applicant for correction with a letter of 



, copy of which is attached hereto. The application was found complete 



as required by the regulation when examined by me on 



District Engineer. 



If the application was complete when first received, cancel the portion of the form which 

 is inapplicable. If returned for correction more than once, the additional dates should be 

 written in the blanks and be initialed by the district forester or the district engineer, as 

 the case may be. Use this form for both preliminary and final power applications and 

 right-of-way grants. 



