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Attach documentation showing petitioner's legal or equitable interest in the property, or if petitioner has the power of eminent domain, please indicate, on attached sheets, by what authority petitioner has such power. Attach a legal description of the property for which this determination is sought. In order for your petition to be deemed complete, the Southwest Florida Water Management District (SWFWMD) must receive five copies of the verified delineation either in the form of certified surveys, depiction on rectified aerial photographs, geo-referenced images, or GPS depiction on aerial photographs of the surveyed delineation. I understand that I have to provide any additional information that may be necessary to complete this petition. I am familiar with the information contained in this petition and to the best of my knowledge and belief, such information is true, complete and accurate. I further certify that I possess the authority to petition for a formal wetland determination in accordance with Section 373.421, F.S. or am acting as the duly authorized agent of a person with such authority. I understand that to knowingly making any false statement or representation in this petition is a violation of Chapter 373.430, F.S. Typed! Printed Name of Petitioner or Agent Corporate Title, if applicable Signature of Petitioner or Agent Date AN AGENT MAY SIGN ABOVE ONLY IF THE FOLLOWING IS COMPLETED: I hereby designate and authorize the agent listed above to act on my behalf as my agent in the processing of this petition for formal wetland determination and to furnish, on request, supplemental information in support of the petition. I am familiar with the information contained in this petition and to the best of my knowledge and belief such information is true, complete and accurate. I further certify that I possess the authority to petition for a formal wetland determination in accordance with section 373.421, F.S. I understand that knowingly making any false statement or representation in this petition is a violation of Chapter 373.430, F.S. Typed! Printed Name of Petitioner Corporate Title, if applicable Signature of Petitioner Date PERSON AUTHORIZING ACCESS TO THE PROPERTY MUST COMPLETE THE FOLLOWING I either own the property described in this petition or I have legal authority to allow access to the property, and I consent to a formal determination being made on the property as described in section 40D-4.042, F.A.C. I authorize representatives or personnel from the SWFWMD, after prior notification, to enter the property as many times as may be necessary to make the wetland determination and I will provide access throughout the property sufficient to perform the determination. I will attach to this petition documentation demonstrating that I am the owner of the property or that I have legal authority to allow access to the property. Typed! Printed Name Corporate Title, if applicable Signature Date FORM 547.27/FJDS (8-94) Rule 400-1.659, FAC. Page 3 of 3