1. (a) Application for approval for treatment by aerial methods shall be made on “Form Aerial Application for a Special Permit” provided by the division.
2. (b) Information submitted in support of proposed treatment shall be complete and any falsification of information shall result in denial or revocation of the special permit.
3. (c) Applications shall be completed by the applicant and be received by the division not less than 120 days prior to proposed treatment date.
4. (d) Applicants shall submit an original and 5 copies of the application, map of area to be treated, and other supporting information as specified in Pes 506.02(e).

5. (e) Applicants shall provide the following:

   1. (1) Name, address, telephone, and fax number and pesticide license number of applicator;
   2. (2) Name, address, telephone, and fax number of person(s) requesting the application of pesticides;
   3. (3) Reason why the application of pesticides, or treatment, is necessary;

   4. (4) Description of the pesticide application, including:

      1. a. Target organism(s);
      2. b. Method of application;
      3. c. Method and frequency of calibration of equipment;
      4. d. Name(s) of pesticides, active ingredients and amounts to be used;
      5. e. Labels of pesticides to be utilized;
      6. f. Number of applications to be made and approximate dates of application;
      7. g. Size of area to be treated; and
      8. h. Sequence of applications.

   5. (5) Environmental considerations, including:

      1. a. Management techniques to protect the environment and the health and property of persons in the treatment area and adjacent notification zone; and
      2. b. Justification for use of one pesticide over another;

   6. (6) Description of treatment area including detail maps of a scale of one inch to 1320 feet showing the following:

      1. a. Treatment area(s);
      2. b. Surrounding area;
      3. c. Location of public and private wells and other types of water supplies within the treatment area and in the surrounding area for a distance of 1320 feet from boundary of treatment area(s);
      4. d. Other sensitive areas including surface waters, pasturage, residential dwellings, seasonal camps and other structures; and
      5. e. Roads including access roads.
   7. (7) Description of activities within and around the treatment area;
   8. (8) A list of all property owners having property within 1320 feet of the treatment area;
   9. (9) Considerations being given and measures to be utilized to protect persons, who, by virtue of land use or property ownership within 1320 feet of the treatment area, might have a direct and irrefutable interest in the proposed treatment;
   10. (10) A statement that all information provided is accurate and true, and that falsification of information shall result in denial of the special permit; and
   11. (11) Date and signature of applicant.

Source. #2666, eff 4-3-84; ss by #2781, eff 7-26-84; ss by #4867, eff 7-19-90; ss by #6258, eff 5-30-96; ss by #6834, eff 8-26-98; ss by #8131, eff 8-13-04; ss by #10333, eff 5-10-13; ss by #14064, eff 8-22-24