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4. Are Forest Service roads/easements involved with accessing your development? Ye No (Circle) <br />If yes, explain: <br />10. What County maintained road(s) will the development be accessing from? <br />11. Application is hereby made for permit(s) to authorize the activities described herein. I certify that <br />I am familiar with the information contained in this application, and that to the best of my <br />knowledge and belief such information is true, complete, and accurate. I further certify that I <br />possess the authority to undertake the proposed activities. I hereby grant to the agencies to which <br />this application is made, the right to enter the above-described location to inspect the proposed and <br />or completed work. <br />12. Are there any other pending applications associated with the property associated with this application? <br />E]Yes No <br />Signa Autho ' ed Agent: Dale: <br />X as./Y_ 3 `o <br />Signature of Land Owner of Record <br />{Requiredforapplicatio ubmittal): Date: <br />G DRIVFJCDS FOMMPL,ANN[NG/DEVELOPMEN''r AC FvME5 APPLICATIONILONG PLAT APP:.' UPDATED 1A 12007 <br />3 of 3 <br />