UW-Madison Lakeshore Nature Preserve

Geocache Permit Request Form

(July 10, 2009)

Instructions: Read and understand the Geocache policy. 

Send us your information any of these ways: Send to: cbruner@fpm.wisc.edu

• Copy and paste this data into an email
• Email us and attach a fillable PDF of the permit
• Email us and attach a printable Word version of the permit

A permit is valid for 12 months from the date approved. After that date, the cache must be moved and a new location permitissued or the cache must be removed from the premises.

Cache Owner Information:

Name____________________________________________________

Address__________________________________________________

Phone number ____________________________________________

E-mail address ____________________________________________

Cache name as listed on geocaching.com:_______________________

Physical description of container_______________________________

Location coordinates ______________________________________

Physical description of area_________________________________

I hereby request permission to place a geocache on lands managed by the Lakeshore Nature Preserve. I agree to comply with the provisions of Preserve policy on geocaching.  I understand that I am to monitor this cache quarterly and maintain it in a safe and secure manner. I understand that caches not in compliance with the terms of this permit will be removed from the property and this permit will be voided.

Name of Applicant____________________________________

Permit approved by __________________________________

Permit expiration date_________________________________

Permit denied by ____________________________________

Reason for denial____________________________________