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-3- <br />Af cer the appl icat Lo^ has been :_i _d vi[h [he Division, ^otic_ pro- <br />cedures outlined ir. Section 3.2 ar ~ = (vhicaever is app Licab le) nusc 'oe <br />followed. <br />I' ADDITIT,;?1 I::P02~ ~TiS: <br />' :'his space can be referenced for :archer in`ormat!on of any of the items <br />on this forn. <br />To me best o° my :<not: Lag ^y e, 21_ the 1::FOl=3L _OR ores ented in t'n i:: app l'_ca ccn <br />Ls crue a:d cor re cc. <br />t <br />i~ <br />r <br />i <br />~ / (- , ; .~ <br />g.: _ :.1; 1 .. _ <br />Titi eo I_ 1 -_ <br />(Sivred by iadiv kcal legally a'.: c::^.or!z aL <br />~--- <br />to bir~ . ooe~a ror o chis ap pl'_cecimt) <br />Pre Pa red bY: ~_'~~/<C .,~. ~.`.~J_ <br />-R.~`si"ep en Schermerhorn, P.E. <br />President <br />IMPACT Environmental Consultants <br />