Name of Applicant) (Organization Or School

A FISH RESOURCE PERMIT is required to take, possess, hold alive, or tag FISH AND THEIR EGGS (except goldfish and decorative tropical fish) FOR SCIENTIFIC OR EDUCATIONAL PURPOSES.

(in order to use this form over again as a “blank form” first re-name and save this as a new document)

Jim Petropulos / Alaska Department of Transportation and Public Facilities

(Name of Applicant) (Organization or School)

Environmental Section, Southeast Region 6860 Glacier Highway P.O. Box 112506Juneau, AK99811-2506

(type in complete mailing address including City, State, and Zip Code)

(907) 465-1851 / (907) 465-3506 /

(your Telephone Number) (Fax Number) (Email Address)

(type in the name and address of the organization with which you are under contract)

I am making application to capture fish of the following species and number for the specified disposition (example: identify and release, measure and release, genetic sample and release, tag and release, sacrifice, transport, hold alive, etc.):

Species Species

Common Name Scientific Name Life Stage Number Disposition*

pink salmon / Oncorhynchus gorbuscha / adult/juv. / as needed / Identify & Release (IR)
chum salmon / Oncorhynchus keta / adult/juv. / “ / IR
sockeye salmon / Oncorhynchus nerka / adult/juv. / “ / IR
coho salmon / Oncorhynchus kisutch / adult/juv. / “ / IR
king salmon / Oncorhynchus tshawytscha / adult/juv. / “ / IR
cutthroat trout / Oncorhynchus clarki / adult/juv. / “ / IR
rainbow trout / Oncorhynchus mykiss / adult/juv. / “ / IR
Dolly Varden char / Salvelinus malma / adult/juv. / “ / IR
stickleback / Gasterosteus aculeatus / adult/juv. / “ / IR
freshwater sculpin / Cottidae / adult/juv. / “ / IR

*For multiple sample locations give detail of species and number and disposition in your study plan

I understand permits are only valid for dates within a calendar year; I am requesting this permit for the following period: (a new application is required each year)

2008 / January 1 / December 31

Year: (20 ) From: (month and day) To: (month and day)

I wish to obtain the above fish [finfish, shellfish, amphibians] by means of:

Minnow traps, dip nets, beach seines

(Specify gear type(s): minnow traps, hoop traps, fyke nets, gillnets, dip nets, spat collectors, etc.)

from the following location(s):

We anticipate relocating fish from project areas throughout Southeast Alaska such as in the Juneau, Hyder, Ketchikan, Wrangell, Sitka, Petersburg, Prince of Wales, Petersburg, Skagway and Haines areas.

(Specify location(s), i.e., X River at latitude/longitude, or ESE of Pt. Barrow, or on Kodiak Island, etc.)

The purpose of the activities for which a permit is being requested: (a brief purpose statement)

Relocating fish to avoid mortality and stress from permitted ADOT&PF construction and maintenance activities, and identifying fish streams and species during project design and permitting phase.

(this area and other boxes will expand as you type)

NOTE: A STUDY PLAN or RESEARCH PROPOSAL explaining the purpose and need, the objectives, and the procedures you will use must be included in/with this permit application:

Purpose and Need:
DOT&PF construction and maintenance projects sometimes affect anadromous and resident fish habitat, most commonly at culverted stream crossings, but also by road realignments, and riprap installations. DOT&PF Environmental Section staff are trained in fish identification and relocation techniques, which they use to clear work areas before construction occurs. During project design and permitting DOT&PF needs to identify fish streams and species to develop appropriate measures to avoid or minimize impacts and to assure fish passage.
Proceedures:
The need to relocate fish from a project work area will be included as a condition in a Fish Habitat permit obtained for the project from DNR OHMP. Trained DOT&PF staff will typically isolate the work site with 0.125 or 0.25 inch vexar mesh, place minnow traps baited with Betadyne-treated salmon eggs, and relocate trapped fish to a nearby undisturbed area in the same waterbody. Species and numbers of trapped fish are tallied and any mortality is noted for reporting to ADF&G. Minnow trapping is usually used to capture juvenile rearing fish and small resident fish.
If practicable, a 0.125 mesh minnow seine is used to clear most of the fish out of ponds and stream reaches prior to using minnow traps. This method would also be used in the rare emergency case where we might be moving or excluding adult fish from a worksite. Fish trapped during project reconnaissance will be identified by species and returned to the location of origin.
Benefits:
Fish relocation from work areas reduces construction impacts to fish populations and individuals. Using DOT&PF staff reduces cost, workload, and logistical demands for ADF&G and DNR and provides flexibility for timing of construction activities.

(Study Plan)

Final disposition of collected specimens* not to be released live at the site of capture will be:

Fish will be transported out of the project work limits and released into the same water body.

*(specimens may not be consumed, sold, traded, or bartered, or used in any commercial manner)

The following people will participate in field collections under terms of this requested permit:

Carl Schrader / Amanda Luecker
John Barnett / Reuben Yost
Amy Mcleod / Ron Wyman
Jane Gendron / Mandi Bolshakoff

(If applicant is representing a corporation or institution, a certification of affiliation may be required which must be notarized and attached to this application).

Fish Resource Permit Application – Email Form (11/2006)Page 1 of 2

( completed application must be submitted to ):

Email Address:

Freshwater and estuarine environment collections (Division of Sport Fish):\

Marine environment collections (Division of Commercial Fisheries):

Mailing Address:

Fish Resource Permit Application – Email Form (11/2006)Page 1 of 2

Freshwater & estuarine environment collections:

Alaska Department of Fish and Game

Attn: Bob Piorkowski

Division of Sport Fish-RTS/FR Permits

P.O. Box 115526

Juneau, AK 99811-5526

Marine environment collections and permits involving propagation. :

Alaska Department of Fish and Game

Division of Commercial Fisheries

Attn: Sara Larsen

P.O. Box 115526

Juneau, AK 99811-5526

Fish Resource Permit Application – Email Form (11/2006)Page 1 of 2