Application is made for a permit to conduct research activities on state lands at the following location:(site/town/county)

The research activities to be undertaken are fully described in the proposal attached to this page, and include:

• hypotheses being tested
• research goals
• field methodologies
• crew characteristics (with resumes)
• techniques of collection, excavation, data recovery and analysis
• facilities for treatment, preservation and storage of materials
• disposition of artifacts and specimens

Signature of Applicant: _________________________ Date:__________

Attach firmly to proposal and forward to Room CEC 3097, Empire State Plaza, Albany, NY 12230.
Do not write below this line.

Recommendation:       Approval      Approval with conditions       Disapproval