PERMIT Permission i hereby granted t Paani Name Duet Tape Then Beer LLC. UTU-90997 {o use the following National System of Public Lands: Locations ‘Com Ridge (Monarch Cave, Procession Panel, Cold Springs Cave/Eagle’s Nest, Upper Comb Ridge near Tower House) and Valley of the Gods Road (See attached maps) Meridian ‘State County ‘Acres (number) SALT LAKE UTAH Sen Juan t for the purpose of filming and still photography and subject to the following conditions: | This permits issued forthe period specified below. It ‘next, orderly, and sanitary condition, Preeti edhe Site ihoneed eer 9. Remi tl py anand os aac, Ee ee erred FER eee POBR eas See tern a cate de shee eo 10. Permits shal kell reasonable precaution to ern, od 2 Thigpen gai al apleateproions othe Pete paulo wes onan te Say ae regulations (43 CFR 2920) which are made a part lands. hereof. 11. Permittee shall not cut any timber on the lands or 3, This permit may note assigned without ror pproval eee en ee eS _ReOR onan seg cba rss ate bea ee Ee eT ee Lay 4. Permittee shall not enclose roads or trails commonly in. Gr ‘market value for the timber oF other resources. aOR atte Safetsen ae 12 Tigpemt gaa oe rvs of cue, ee ee aso aman, 5. Authorized representatives ofthe Department of the es Ne LIAS of Serer 4, LOS ama interior, other Federal agencies, and State and Toca law oficial shall tall mes have the right to enter the premises on official business 6. Permitice shall pay the United States fr any damage to its property resulting fom the use. opy ofthis order may be obtained from the signing 13, Permit acknowdge, by signing Below, that hese Kaien oi ae ie tein Sulton urder whi frm aed 1. Pemitee shal oi the authorized office of ade Remit sal nay 14. SEE ATTACHED STIPULATIONS 8. Permittee shall observe all Federal, State, and locel laws and regulations applicable to the premises and to erection or maintenance of signs or advertising displays Inciting the eglations forthe protection of game birds and game animals, and shall keep the premises in Permit issued for 4 days of filming and still photography at the specified locations. soma llc Qate — To: sam7014 ‘Ths Paporwu Reduction Act 1980 (44.380 grees wo ino 9p ha Information & necded to process application for land se authorizations, pursuant o 43 CFR Section 2920, Tnformation shows if the applicant and proposed use rect the resutemnents of 43 CER Section 2920 "Applicant must respond before hele can be granted an authorization to uss public lands.STIPULATIONS FOR FILM PERMIT UTU-90997 Duct Tape Then Beer LLC. All vehicles will remain on designated roads, turnouts, and parking areas, ‘The company will provide the BLM Monticello Field Office with a filming schedule for locations ‘on public lands and keep the schedule up to date. The BLM contact person is Chris Ransel (435) 587-1522. ‘The company is required to have a monitor on location at all times when setting up and filming in the authorized BLM locations. The monitor must be selected from the attached list of approved compliance monitors. The BLM must be notified of the selection of monitor prior to the issuance of the permit. ‘The company will have a copy of the BLM film permit at all times when filming in the BLM locations. 5. The final filming product will have written and/or verbal acknowledgment of filming location on public lands managed by the Bureau of Land Management, Moab Field Office, Utah, if feasible. The Paperwork Reduction Act of 1980 (44 U.S.C. 3501 et seq) requires ustoinfom you that: Information fe nesde spre appleation fr land xe auherizaion:pursat 043 CPR Section 2220, Information shows (ihe applicant and proposed use mex he reqaement of 43 CF Section 2920.1 "Applicant mast respond Wefore hehe ean be granted an aorzation ose public landsUnited States Department of the Interior Bureau of Land Management Categorical Exclusion Not Established By Statute DOI-BLM-UT-Y020-2014-035-CX December 2014 Film Permit — Duct Tape Then Beer LLC. UTU-90997 Locations: SLM, T.378.,R. 20E., sec. 12, 13, 24 ¥.378.,R.21E., sec. 7, 18, 19 T.39S,,R. 21 E,, sec. 30, 31 T.40S.,R. 18 E., sec. 33, 34, 35 T.40S.,R. 19 E., sec. 17, 18, 20, 21, 22, 27, 29, 30, 31, 34 T.418,,R. 18E,, sec. 1 T.41S.,R. I8E., sec. 3, 6, 10 T.40S.,R. 21 E., sec. 24 Applicant/Address: Duct Tape Then Beer 2019 NE 105™ St. Seattle, WA 98125 Bureau of Land Management Monticello Field Office 365 North Main Street (P.O. Box 7) Monticello, Utah 84535 Phone: 435-587-1500 Fax: 435-587-1518CATEGORICAL EXCLUSION DOCUMENTATION FORMAT WHEN USING CATEGORICAL EXCLUSIONS NOT ESTABLISHED BY STATUTE A. Background BLM Office: Monticello Field Office Lease/Serial/Case File No: UTU-90997 Proposed Action Title/Type: Film Permit - Documentary Filming and Still Photography Locations of Proposed Action: Valley of the Gods road and Comb Ridge (Monarch Cave, Procession Panel, Cold Springs Cave/Eagle’s Nest, Tower House) Description of Proposed Action: On November 5, 2014, Fitz. F Cahall, on behalf of Duct Tape Then Beer LLC, filed film permit application UTU-90997 for 4 days of filming from December 2, 2014 through December 5, 2014. The company has requested the permit to complete filming and still photography for a documentary of an individual. The company requested the permit to film at the following locations; Valley of the Gods Road and several locations at Comb Ridge (Monarch Cave, Procession Panel, Cold Springs Cave/Eagle’s Nest, Tower House). The crew consists of 4 people traveling in 1 transport vehicle. The camera equipment will be hand-held with the use of atripod. No surface disturbance is expected because the crew is small and minimal equipment will be used for filming and photography. B. Land Use Plan Conformance Land Use Plan Name: Monticello Field Office RMP, Approved November 2008 The proposed action is in conformance with the applicable LUP because it is specifically provided for in the following LUP decision(s): LAR-6 Filming permit authorizations are subject to Public Law 106-206. Applications for filming permits in the Monticello PA will be limited to existing highways, roads, and pullouts and previously disturbed or cleared areas throughout the Field Office (including Valley of the Gods, Moki Dugway, Highway 211, Newspaper Rock, and Highway 95) and will have to meet ..... criteria of minimal impact to be approved without any NEPA analysis. C. Compliance with NEPA The Proposed Action is categorically excluded from further documentation under the National Environmental Policy Act (NEPA) in accordance with 516 DM 11.9(E)19. This reference states “issuance of short-term (3 years or less) rights-of-way or land use authorizations... where the proposal includes rehabilitation to restore the land to its natural or original condition.” This categorical exclusion is appropriate in this situation because there are no extraordinary circumstances potentially having effects that may significantly affect the environment. The proposed action has been reviewed, and none of the extraordinary circumstances described in 43 CER Part 46.215 will apply.A copy of the notice of appeal, any statement of reasons and all pertinent documents must be served on each adverse party named in the decision from which the appeal is taken and on the Office of the Regional Solicitor, U.S. Department of the Interior, 6201 Federal Building, 125 South State Street, Salt Lake City, Utah 84138-1180, not later than 15 days after filing the document with the Authorized Officer and/or IBLA. Authorizing Official: 2 > anh. he, fe Date:_/2, Jt hy Donald Hoffheins, Field MarlagerApproval and Decision Thave reviewed this plan conformance and NEPA compliance record and have determined that the proposed project is in conformance with the Monticello Field Office RMP, approved November 2008, and that no further environmental analysis is required. It is my decision to grant land use permit UTU-90997 to Duct Tape Then Beer LLC of 2019 NE 105TH St., Seattle, WA 98125 pursuant to the authority of Section 302(b) of P.L. 579, October 21, 1976 (43 U.S.C. 1732). The permit will authorize 6 days of filming on public lands within the Monticello Field Office. The permit will be made under the authority of and be subject to the terms and conditions in 43 CER 2920 and rental payment as determined by the film permit schedule (Instruction Memorandum UT 2010-043). The permit also will be subject to the standard stipulations of the land use permit Rationale: The proposal meets the criteria for minimum impact filming in WO Instruction Memorandum 96-148 and the guidelines in 43 CFR 2920.2-2 and is therefore, a full force and effect decision. The proposed action is not ina WSA or area with special designation. The proposed action would not result in unnecessary or undue environmental degradation, This decision shall take effect immediately upon the date it is signed by the Authorized Officer and shall remain in effect while any appeal is pending unless the Interior Board of Land Appeals issues a stay. Any appeal of this decision must follow the procedures set forth in 43 CFR Part 4. Within 30 days of the decision, a notice of appeal must be filed in the office of the Authorized Officer at 365 North Main Street (P.O. Box 7), Monticello, Utah. Ifa statement of reasons for the appeal is not included with the notice, it must be filed with the Interior Board of Land Appeals, Office of Hearings and Appeals, U.S. Department of the Interior, 801 North Quincy St., Suite 300, Arlington, VA 22203 within 30 days after the notice of appeal is filed with the Authorized Officer. If you wish to file a petition for stay pursuant to 43 CFR Part 4.21(b), the petition for stay should accompany your notice of appeal and shall show sufficient justification based on the following, standards: 1. The relative harm to the parties if the stay is granted or denied, 2. The likelihood of the appellant’s success on the merits, 3. The likelihood of irreparable harm to the appellant or resources if the stay is not granted, and 4, Whether the public interest favors granting the stay. If a petition for stay is submitted with the notice of appeal, a copy of the notice of appeal and petition for stay must be served on each party named in the decision from which the appeal is taken, and with the IBLA at the same time it is filed with the Authorized Officer.D. Signature Authorizing Official: » AL, & Donald Hoffheins Field Manager E, Contact Person For additional information concerning this CX review, contact Chris Ransel Realty Specialist Monticello Field Office 435-587-1522 F. Attachments * Categorical Exclusion Review Record © MapsCategorical Exclusion Review Record DOI-BLI IT-¥020-2014-035-CX Film Permit - Stills and film for documentary UTU-090997 Valley of the Gods Road and Comb Ridge (Monarch Cave, Procession Panel, Cold Springs Cave/Eagle’s Nest, Upper Comb Ridge) The following elements are not present in the Monticello Field Office and have been removed from the checklist: Farmlands (Prime or Unique), Wild Horses and Burros Resource YesiNo* Assigned Specialist | Date ignature Air Quality No O4 Ti Floodplain No watery Water Quality (drinking or No ground) L iabfiy Wetlands / Riparian Zones No lastly it No Areas of Creal Environmental tp MUD a Wild and Scenic Rivers No a ~ vali Wilderness No ee 214 i No Fnac Native Binaiean Religious DS hte, 1 ty hy Cultural Resources No = Langs 1ap/M4 Environmental Justice No Lb LLY Wastes (hazardous or solid) No rahi LY Threatened, Endangered, or No @ Candidate Animal Species Buz hel) \abligd Migratory Birds No Ba LED wh 1 Threatened, Endangered, or No g Candidate Plant Species liu 24) aly Invasive Species/Noxious No 7 Weeds 4 Yap lee Other: No . “Extraordinary Circumstances apply. ZL Environmental Coordinator: Date: a fiJ/Y fo AZ aliifUTA~ 09957 Oo Indicate locations of interest for application Application: Fitz Cahall, 206-890-9533, Dec 2-5, 2014UTL.090997