A. OWNER/APPLICANT ACKNOWLEDGEMENT
By signing below, I, or the business organization, am notifying the EPC of my intent to use an exemption. I am familiar with the information contained in this form and represent that such information is true, complete and accurate. I understand this is a notice and not an application for a permit, and that work prior to EPC verification or beyond the scope of the exemption may be a violation. I understand that this form and any exemption verification 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 the law. I understand that my notice will not be processed if there is any missing, insufficient, or invalid information. I understand that knowingly making any false statement or representation in this form is a violation of the EPC Act and rules and may result in denial of the exemption.