Please be advised, due to the current State assumption of the federal Section 404 Clean Water Act program, all wetland and other surface water boundary delineations accepted by the EPC will be subject to future State review prior to being accepted by the Florida Department of Environmental Protection or the Southwest Florida Water Management District.  EPC lines may not be accepted by the State and will be subject to future modification by the State agencies.  The delineation of the boundary will be based on the same wetland or other surface water methodology adopted in Section 62-340, Florida Administrative Code, however, the lines must be field verified by the State prior to being accepted under the 404 program.                                                                           

A.  OWNER/APPLICANT ACKNOWLEDGEMENT

By signing below, I or the business organization, am applying for a permit(s)¹ to conduct the activity(ies) described in the application. I am familiar with the information contained in the application and represent that it is true, complete and accurate. I understand this is an application and not a permit, and that work prior to approval may be a violation. I understand that this application and any permit issued thereto, does not relieve me of any obligation for obtaining any other required federal, state, water management district or local permit prior to commencement of activities. I agree to operate and maintain the proposed activity in compliance with permits and laws, unless the EPC authorizes transfer of the permit to a different responsible entity. I understand that my application will not be processed if there is any missing, insufficient, or invalid information or insufficient fees. I understand I may have to provide any additional information/data that may be necessary to provide reasonable assurance of evidence to show that the proposed project will comply with applicable environmental standards/laws. I agree that upon written concurrence, the EPC may make changes to the application based on revised drawings and/or additional information provided by agent or applicant. I further agree EPC can unilaterally change non-substantive typographical errors. I understand that knowingly making any false statement or representation in this application is a violation of EPC Act and rules and may result in, among other things, revocation of the permit or denial of the application.

By signing below, I certify that I, or the business organization, possess sufficient real property interest in or control over the land upon which the activities described in this application are proposed and that I have legal authority to grant permission to access those lands. I hereby grant permission, evidenced by my signature below, for staff of the EPC to access, inspect, and sample the lands and waters of the property as necessary for the review of the proposed works and other activities specified in this application. I authorize EPC, its agents, and assigns to enter the property as many times as may be necessary to make such review, inspection, and/ or sampling. Further, I agree to provide entry to the project site for such agents or personnel to monitor and inspect permitted work if a permit is granted.

C.  DESIGNATION OF AUTHORIZED REPRESENTATIVE (IF APPLICABLE)

By signing below, I authorize the representative listed below to act on my behalf, or on behalf of the organization, to process the application; to negotiate revisions; to accept or agree to conditions or stipulations; and to furnish, upon request, supplemental information in support of the application. In addition, I authorize the representative listed below to bind me, or the organization, to perform any requirements that may be necessary to procure the permit or authorization.