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(9) SIGNATURES FOR JOINT APPLICATION <br />Application is hereby made for the activities described herein. I certify that I am familiar with the information contained in the <br />applicarion, and, to the best of my knowledge and belief, this information is true, complete, and accurate. I further certify that <br />I possess the authority to undertake the proposed activities. By signing this application I consent to allow Corps or Dept. of <br />State Lands staff to enter into the above-described properiy to inspecting the project location and to determine compliance with <br />an authorization, if granted. I herby authorize the person identified in the authorized agent block below to act in my behalf as <br />my agent in the processing of this application and to furnish, upon request, supplemental information in support of this permit <br />application. ~ <br />I understand that the granting of other pernuts by local, county, state or federal agencies does not release me from the <br />requirement of obtaining the permits requested before commencing the project. I understand that payment of the required <br />state processing fee does not guarantee permit issuance. The„~ for the state application must accompany the application for <br />completeness. Amount enclosed $;~QQ. * <br />I certify that T may act as the duly authorized agent of the applicant. <br />~~oT ~~.7` 2 v1 e <br />~~~^,r~-t ~o lv i n ~ro e~ yr~c/' <br />o <br />Pnnt !`Type Name Title Print /Type Name Title <br />~ -1 (!a (O"~ <br />Applicant Signature Date Authorized gent Signature Date <br />Landowner signatures: For projects and /or mitigation work proposed on land not owned by the applicant, including state-owned <br />submer ed and submersible lands lease rovide si atures below. <br />I certify that the applicant has my permission to conduct the I cert~ that the applicant has my permission to conduct the <br />project on my property. * proposed rrtitigation on my property. I also understand this may <br /> involve long term protection and monitoring of the mitigation <br /> area. * <br />Print /Type Name Title <br />' Print /Type Name . Title <br />Property Owner Signature Date <br /> Mitigation Property Owner Signature Date <br />~ <br />Page 8 <br />