Navigation Center
United States Coast Guard
U.S. Department of Homeland Security

Application For Marine Event Permit

Privacy Act Statement

Pursuant to 5 U.S.C §552a(e)(3), this Privacy Act Statement serves to inform you of why DHS is requesting the information on this form.

AUTHORITY: 14 U.S.C. § 70041 authorizes the collection of this information. The Coast Guard Navigation Center will use this information to disseminate navigation safety notices and updates to individuals upon request and to receive reports of aid to navigation outages, issues or discrepancies.

PURPOSE: The Coast Guard will use this information to determine whether a marine event poses an extra or unusual hazard to the safety of life and whether or not, and under which conditions, to permit the event on the navigable waters of the United States.

ROUTINE USES: Authorized USCG personnel will use this information to evaluate the marine event request.  Any external disclosures of information with this record will be made in accordance with DHS/USCG-013.  Marine Information for Safety and Law Enforcement (MISLE), 74 Federal Register 30305 (June 25, 2009).

CONSEQUENCES OF FAILURE TO PROVIDE INFORMATION: Furnishing this information is strictly voluntary.  However, failure to provide this information may delay or prevent the approval of the marine event.

An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number.  The Coast Guard estimates that the average burden for this report is 60 minutes.  You may submit any comments concerning the accuracy of this burden estimate or any suggestion for reducing the burden to:  United States Coast Guard, Commandant (CG-WWM-1) Stop 7509, 2703 Martin Luther King Jr. Ave SE, Washington, DC. 20593-7509 or Office of Management and Budget, Paperwork Reduction Project (1625-0008), Washington, DC 20593.

FORM INSTRUCTIONS

  1. This application must reach the appropriate USCG Sector at least 135 days prior to the event.  A list of sectors has been provided for you below in Question 3a.
  2. Attach a section of a chart or a scale drawing showing boundaries and/or courses and markers contemplated.
  3. Click "Submit Message" once you completed the form.  If you need to send additional requirements, any special rules pertaining to equipment rigs, or procedures, please send documention via email to [NAVCEN-Web-Homeport-Main-Event@uscg.mil] a copy of your entry requirements and any special rules pertaining to equipment rigs, or procedures.

* Denotes required fields.

Today's Date

2a. Start Date and Time of Event:

2b. End Date and Time of Event:

Leave blank to use the time of form submission.
3b. Select Location of Event on the Map:

To define an area for your event, please use the map below, or enter Decimal and Degrees of requested area in the following fields. NOTE: Please enter numbers only. If you need assistance in converting, please click HERE.
To use the map, locate the Draw Rectangle tool () on the left side. Click the tool, then click on the map to set the upper left corner of your requested area. Then move the mouse to the bottom right corner of your requested area and click once more. The coordinates of the area you selected will automatically appear in the appropriate form fields. You can use the Remove Layers tool to remove an area as well. Click on the Remove Layers tool (Atoms/Icons/Tools/EraserCreated with Sketch.), then click on the area to remove, then click Finish.
 

Enter any value from -90.000000 to +90.000000. An example is 59.123456
Enter any value from -180.000000 to +180.000000. An example is 132.123456.
Enter any value from -90.000000 to +90.000000. An example is 59.123456
Enter any value from -180.000000 to +180.000000. An example is 132.123456.
Please provide explanation if 11 is "Yes."
(e.g. 1234567891)
The undersigned has full authority to represent the sponsoring organization.

2b. End Date and Time of Event:

Leave blank to use the time of form submission.