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8. Are Forest Service roads/easements involved with accessing your development? Yes No (Circle) <br />Ifyes, explain: NO <br />What County maintained road(s) will the development be accessing from? GAME FARM ROAD <br />10. Application is hereby made for pertnit(s) to authorize the activities described herein. I certify that I am familiar with <br />the information contained in this application, and that to the best of my knowledge and belief such information is <br />true, complete, and accurate. I further certify that I possess the authority to undertake the proposed activities. I <br />hereby grant to the agencies to which this application is trade, the right to enter the above-described location to <br />inspect the proposed and or completed work. <br />All correspondence and notices will he mailed to the Land Owner ofRecord and conies sent to the authorized aeent. <br />Signature of Authorized Agent: Date: <br />RE UIRL•D if indicated on a lication <br />X <br />Signature of Land Owner of Record <br />(Required for application submittal): Date: <br />G DR1VE;CDS FORMS/PLANNING/LAND USE APPS/LONG PLAT APP UPDATED: 1/1/08 <br />3OF3 <br />