200 2009 Kaua‘i Seabird Habitat Conservation Plan Application Template The application template provides a convenient method for the applicant to provide the information necessary to obtain coverage under the KSHCP and fulfill application requirements for an Incidental Take License (ITL) from the Department of Land and Natural Resources, Division of Forestry and Wildlife (DOFAW) and an Incidental Take Permit from the U.S. Fish and Wildlife Service (USFWS). The applicant’s information will be attached to the KSHCP as an appendix. The public draft KSHCP will be reviewed along with the applicant’s information by the Board of Land and Natural Resources (BLNR) pursuant to HRS Chapter 343. The BLNR will issue public notification of the proposed KSHCP and ITL for public review and comment through the Office of Environmental Quality Control (OEQC) bulletin, and will hold a public meeting on Kaua‘i. Information you provide will remain confidential until the notice is published in the OEQC bulletin. KSHCP APPLICATION TEMPLATE Complete all items in Part I and II of this application by pasting or typing in answers to each item below. Any inconsistencies in font type and size will be corrected by KSHCP staff. The information you provide below describes what will be covered by the permits. KSHCP staff will contact you regarding any incomplete information pertaining to this application. If you have any questions please feel free to call us at the contact information below. PART I. Item 1. Name of contact for applicant, business, agency, or institution and contact phone number. If different than the landowner, please include power of attorney from the landowner: Item 2. Identify the locations of the proposed facilities and activities by address and tax map key number and a map(s) of facilities: Item 3. Describe the facilities and activities for which incidental take coverage is sought, including lights (descriptions of make, model, and style), buildings, and structures. A table format is preferred: Item 4. If applicable, describe lighting standards that you must enforce pertinent to lights and other structures which may affect seabirds (e.g. requirements for minimum foot candles per area in security areas): Item 5. Describe all site-specific avoidance and minimization measures considered for facilities/activities listed separately by facility/activity. This item should include any recommendations made by DOFAW and USFWS: Item 6. Describe planned avoidance and minimization measures, including estimated schedule and cost as a table (preferably). In this item, the applicant can denote measures already implemented or completed (new lights, shields, or underground utility lines). If applicable, the applicant should provide the reasoning why certain measures would not be implemented: Kaua‘i Seabird Habitat Conservation Plan Application Template 1 Item 7. Describe any training(s), including worker seabird awareness training, related to seabird monitoring at facilities/activities. Please provide the dates, names of personnel in attendance, and a brief description of what was or will be covered in the training: Item 8. Describe all planned monitoring activities, including schedules and staff hours dedicated towards seabird search and recovery, light avoidance and minimization management, and any other monitoring activities: Item 9. Describe any outreach conducted, if applicable (e.g., handing out pamphlets on seabird awareness to facility guests): PART II. This part of the application will be developed in consultation with DOFAW and USFWS. Item 1. Show calculation of estimated take for each species: Item 2. Select the requested take coverage from the tiers listed in the KSHCP Framework for each species. If different than that of estimated take, please explain: Approved licenses are valid only with proof of adequate funding source to ensure that the proposed measures and actions, including monitoring, are undertaken in accordance with the schedule1. CONTACT US Call the KSHSCP Office at (808)245-9169 or (808)346-3489 or visit our office at 4139C Hardy Street, Lihu‘e. The project website is www.Kauai-seabirdhcp.info. We look forward to working with you toward helping Hawai‘i ’s unique species! 1 The applicant shall post a bond, provide an irrevocable letter of credit, insurance, or surety bond, or provide other similar financial tools, including depositing a sum of money in the endangered species trust fund created by section 195D-31, or provide other means approved by the board, adequate to ensure monitoring of the species by the State and to ensure that the applicant takes all actions necessary to minimize and mitigate the impacts of the take. Kaua‘i Seabird Habitat Conservation Plan Application Template 2