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DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF FISH AND WILDLIFE PERMIT APPLICATION FORM Permit Renewals: Renewal * Please provide the following: Any changes to permittee(s) information or project work to be done. If none, please provide items in sections 1.b – 1. c and sign/date application. A copy of expiring/expired permit. Final report, or estimated submission date for final report (published article, dissertation, thesis can be submitted in lieu of a final report) Permit Applied for (check all applicable) Endangered Species (local) Scientific (please attach project description) Recovery and/or propagation Collection Retention Mangrove Trimming * If contractor, please submit letter of authorization by property owner to conduct work. Relocation Import Export Educational Island Visitation Name of Applicant: Phone Number: Mailing Address: Physical Address: Email Address: 4. List of “Authorized Personnel” to assist in the completion of the proposed scope of work; including collaborators and final recipients of work products. 5. Target Species: Scientific Name Common Name Quantity Description 6. Rationale for the proposed activity: 7. Methods which will be used in the proposed activity: 8. Details of holding/retention facilities (include dimensions and construction material of cage): 9. Shipping details (method, destination, name/address of applicant(s) or authorized personnel): 10. Description of food source for animals with specialized diets: 11. Location of activity (attach map): 12. Dates of activity: Start: Completion: 13. Attach research proposal. 14. Attach letters of support from all sponsoring institution or organizations. 15. If the primary applicant is a student, please provide letters of support from a direct supervisor. Supervisor must also be named co-applicant and their information provided. Please complete all categories that apply. The processing of this permit may be delayed if the information is incomplete. Please call or email if you should have any questions. Alfonso Garcia Jr Phone 340-773-1082 ext. 2262 Email: alfonso.garcia@dpnr.vi.gov Website: https://dpnr.vi.gov/fish-and-wildlife/ h¸5f hy2k gdy2k h*tw h*tw hJGe hy2k h¸5f h¸5f h¸5f h*tw h*tw h¸5f gd¼P hdy‹ h¸5f h¸5f h'7g h¸5f hy2k h¸5f h¸5f h¸5f h*tw h¸5f hŠjw h¸5f h¸5f c) / YBQ] T gRagá2y9Í°Q g(Så l'×w 9ZD© Z7ñIk1, àpQ% ljÍR º3'y ŸK63W o›.Jm í%q( Wc¦9tdF7j NMiéU) ZJmQû We¸P 8;j†/2juá —ns3 .N1å6 (ÝPf ri;­ uN•W f%ð);xF -vYŽ& T(%ù .F\J Pç-) tTA&Š .7\-a >;Rl úZZa „(Ho7KX 8"$ýU; c.W¾ L0qpB\Lv'† NtON RG I G>7'h .ltº 0‡PIV vr-u' bKZq½ %1oõ :Q^- 5ztê 'ƒA:0 Iqu! h<,A S\#pE7/ ×-xzH c¹0; &"Hï -b­q ’4e/9/ 5v“3xU .”-J $uVÈG ¹aMQ &k¬9 'B,Ò8 YCÃ"t E’AM (P ó BøJR Hg 1A2 R:¤GMT(Tq c©4O —doK QrÆK $VŠ ¹PGw Üwqh YI­n u—iu "a°F œL&A' Œ5uBa "$zÈY zUvÓ ­ zHDNH5{ rPŠl ,'UbH. 9x4 4 xg4ÇZ5PÑrL 0Om¡ 2çDb iô%s F\,u Zoqr 2NGÑ ¢ZFa dL.ÆN a0UaG o>LZ Cc],B ³wUdB pHGg.Ž 9ÂPogxJ ¬CGJ ‡LtD 6AFC Z·vmM7Å;:v ngÕI 7ÈCD (3Õo0.U 6§.F ¤TMt ÇpnM 6o:td, 3C.Dú (¤As&ql¢ mçCc ªfpI Zn]) o¨F" dYqé 0BÔ&j~ml óIs. sVX¤ GuU› Zt %AS q$vPì w"3Bì hátUq ‹olv –ycj GQ_m yPsr æ8#, n$ök (WZ<# mMÐXg «pXS IÜSDq7J2-¹ÞT2x Ý(CO Ç:hp §4­77z8s ZfLó ÈxsO¼q#V é3Zr N-Ó2 .M{x qðvm &k&Î%B v&ZøM7 6Yz%)Ø 9$:äs IK$: MP.H K‰iN 2ºR4" UdK¹bnv;( 1FÁI ¡%Nb b#Ä'‰HBcE9 $3µ0 e‹;r W=cv PEB¹ Ud!$ Cx.ô jÎt7Lm çy6b.0ÞQ GMëQSV7² Xz@d ,V ¯ )`Yw iJE2B Ó68lz /oLò 8¿'1 rhç) ZlÔ$ hZG-p#ƒ ElÇO a/†D ìhn1L c) / YBQ] T gRagá2y9Í°Q g(Så l'×w 9ZD© Z7ñIk1, /Z†1 k„W&l„W& Word.Picture.8 DEPARTMENT OF PLANNING AND NATURAL RESOURCES Donna M. Griffin NormO bjbjt+t+ IHDR gAMA PLTE pHYs ¶×eP'SH% K5 • -KqÆ ÖR5) Sáxo j2T]B ojfÔ HEZbHž Q ›T %´qmw8 jH5QÙÓsVe 3ujKý D&´lC ,8@2T kŽE0KU TmD5 IJ²& efìž&wHT 3qš9 ¹3DJ 9gÆ%nÖ9PX Uiup"Ú¢NJ"SV wel` MfÔ2 uJéq Dî U :&¼& Op°I%re5ß"83‘W l7-†KŽJj U²Vjy 29ÖvR-uœ xn;5$' ]gh( u\HU U\Vn TWV5í sÞGu‰'TSs BYiª o$7÷ ÓJeM Ï/Ju0 tkSç Y j0 S_:X dÎaxp DzH¿ Q(ÛTvRb¾ Ty}u Ce$à TõZVvD T.7· Af'… LDiBÕ q±OM b*eb U`DbC 2#ç, a7+V pE‹P Kda— UCW} 2qs¾ y5QÎ W©LDUG UËM;(6¸w ¤j8h Q"|S o´ns 3%8¤ ÍRlx ThjYY ET]0 i8]MÃNoD K‹B9J% lZ@sl William Coles William Coles DEPT. OF PLANNING/NATURAL RESOURCES Title _PID_GUID àpQ% ljÍR º3'y ŸK63W o›.Jm í%q( Wc¦9tdF7j NMiéU) ZJmQû We¸P 8;j†/2juá —ns3 .N1å6 (ÝPf ri;­ uN•W f%ð);xF -vYŽ& T(%ù .F\J Pç-) tTA&Š .7\-a >;Rl úZZa „(Ho7KX 8"$ýU; c.W¾ L0qpB\Lv'† NtON RG I G>7'h .ltº 0‡PIV vr-u' bKZq½ %1oõ :Q^- 5ztê 'ƒA:0 Iqu! h<,A S\#pE7/ ×-xzH c¹0; &"Hï -b­q ’4e/9/ 5v“3xU .”-J $uVÈG ¹aMQ &k¬9 'B,Ò8 YCÃ"t E’AM (P ó BøJR Hg 1A2 R:¤GMT(Tq c©4O —doK QrÆK $VŠ ¹PGw Üwqh YI­n u—iu "a°F œL&A' Œ5uBa "$zÈY zUvÓ ­ zHDNH5{ rPŠl ,'UbH. 9x4 4 xg4ÇZ5PÑrL 0Om¡ 2çDb iô%s F\,u Zoqr 2NGÑ ¢ZFa dL.ÆN a0UaG o>LZ Cc],B ³wUdB pHGg.Ž 9ÂPogxJ ¬CGJ ‡LtD 6AFC Z·vmM7Å;:v ngÕI 7ÈCD (3Õo0.U 6§.F ¤TMt ÇpnM 6o:td, 3C.Dú (¤As&ql¢ mçCc ªfpI Zn]) o¨F" dYqé 0BÔ&j~ml óIs. sVX¤ GuU› Zt %AS q$vPì w"3Bì hátUq ‹olv –ycj GQ_m yPsr æ8#, n$ök (WZ<# mMÐXg «pXS IÜSDq7J2-¹ÞT2x Ý(CO Ç:hp §4­77z8s ZfLó ÈxsO¼q#V é3Zr N-Ó2 .M{x qðvm &k&Î%B v&ZøM7 6Yz%)Ø 9$:äs IK$: MP.H K‰iN 2ºR4" UdK¹bnv;( 1FÁI ¡%Nb b#Ä'‰HBcE9 $3µ0 e‹;r W=cv PEB¹ Ud!$ Cx.ô jÎt7Lm çy6b.0ÞQ GMëQSV7² Xz@d ,V ¯ 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