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Fish Resource Permit Application
— Email Form —

A FISH RESOURCE PERMIT is required to take, possess, hold alive, or tag FISH AND THEIR EGGS (except goldfish and decorative tropical fish) FOR SCIENTIFIC OR EDUCATIONAL PURPOSES.

(in order to use this form over again as a “blank form” first re-name and save this as a new document)

Dona M Eidam


(Name of Applicant) (Organization or School)

18036 Misty Falls Circle, Eagle River, AK 99577

(type in complete mailing address including City, State, and Zip Code)


(your Telephone Number) (Fax Number) (Email Address)

University of Alaska Anchorage, 3151 Alumni Loop, Ecosystems Biomedical Lab, Anchorage, Alaska 99508

(type in the name and address of the organization with which you are under contract)
I am making application to capture fish of the following species and number for the specified disposition (example: identify and release, measure and release, genetic sample and release, tag and release, sacrifice, transport, hold alive, etc.):

Species Species

Common Name Scientific Name Life Stage Number Disposition*

Alaska blackfish     

Dallia pectoralis

Juveniles, subadults, adults     



Alaska blackfish     

Dallia pectoralis     



Transport then hold alive     

Alaska blackfish

Dallia pectoralis



Transport, hold alive, then sacrifice     
































*For multiple sample locations give detail of species and number and disposition in your study plan
I understand permits are only valid for dates within a calendar year; I am requesting this permit for the following period: (a new application is required each year)


January 1     

December 31     

Year: (20 ) From: (month and day) To: (month and day)
This is likely a one year/multi-year research project (circle one). I intend to submit a comprehensive project completion report by:



Month (xxx) Year (20xx)
I wish to obtain the above fish [finfish, shellfish, amphibians] by means of:

Dip net, minnow trap     

(Specify gear type(s): minnow traps, hoop traps, fyke nets, gillnets, dip nets, spat collectors, etc.)
from the following location(s):

Rabbit Slough at 61.5359/-149.2527; Duck Hunters’ Dog Training Pond at 61.5392/-149.25460; DeLong Lake at 61.1639/-149.9555.

(Specify location(s), i.e., X River at latitude/longitude, or ESE of Pt. Barrow, or on Kodiak Island, etc.)

The purpose of the activities for which a permit is being requested: (a brief purpose statement)

Masters thesis project, to analyze diet and timing of reproduction of invasive blackfish in Cook Inlet Basin. Community outreach including school visits with live specimens. Attempted artificial spawning of blackfish, to study developmental anatomy.

(this area and other boxes will expand as you type)

NOTE: A STUDY PLAN or RESEARCH PROPOSAL explaining the purpose and need, the objectives, and the procedures you will use must be included in/with this permit application:

Every 2-4 weeks for one year, blackfish will be collected from 3 sites, wetlands, stream, and lake. Specimens will be sacrificed, preserved in formalin, and stomach contents analyzed for diet study. Ovary egg development will also be analyzed, to determine timing of reproduction. Ripe fish will be harvested for in vitro fertilization, to attempt to rear larvae and describe developmental anatomy.

(Study Plan)

Final disposition of collected specimens* not to be released live at the site of capture will be:

Reproductively-mature adults will be euthanized, gametes harvested, and carcasses discarded. 5 specimens will be held live in lab aquaria for school visits. All other fish will be sacrificed and preserved for stomach contents analysis.      

*(specimens may not be consumed, sold, traded, or bartered, or used in any commercial manner)
The following people will participate in field collections under terms of this requested permit:

Dona Eidam      



Emily Eidam      



Greg Eidam



Mary Sherbick















( completed application must be submitted to ):

Email Address:

Freshwater and estuarine environment collections (Division of Sport Fish):\
Marine environment collections (Division of Commercial Fisheries):


Mailing Address:

Freshwater & estuarine environment collections:

Alaska Department of Fish and Game

Attn: Bob Piorkowski

Division of Sport Fish

P.O. Box 115526

Juneau, AK 99811-5526

Marine environment collections and permits involving propagation. :

Alaska Department of Fish and Game

Division of Commercial Fisheries-Permits

P.O. Box 115526

Juneau, AK 99811-5526

Fish Resource Permit Application – Email Form (08/2004) Page of 2

FRPAppOL.doc / ©2006 ADF&G

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