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PART 3: <br /> A. OWNER(S) OF LAND B. APPLICANT (IF OTHER THAN OWNER) � <br /> NAME �� NAME ,� <br /> � 1 'l�='' �- �}��,t'4';tn...�:: <br /> COMPANY AND TITLE �_. , , COMPANY AND TITLE <br /> 1�1��\tC`i �f` �1 `` :� e (1 '}",' �� �i ,� ���' t � l� � �1 f � ; � j <br /> ADDRES ,� ADDRESS <br /> ���`� � � 1 : j •,�'1; �`�C`.; � �� 1� 1. �'�i': <br /> CITY, STATE, ZIP CITY, STATE, ZIP <br /> 1 ° <br /> t��#;��'+ �„`,��� 11 r' �_-�,�, <br /> TELEPHONE �j� St:� ,`,�(� ��� � � � �`� TELEPHONE <br /> FAX ':�,' ?' � ,� ', � ` 2 C� ; � ` FAX <br /> C. AGENT AUTHORIZED TO SECURE PERMIT (IF D. CONSULTANT (IF DIFFERENT FROM <br /> AN AGENT IS USED) AGENT) <br /> NAME � [ �,��; ��t NAME <br /> �1/�,�2�� ��Jlk_R;4c�� <br /> Dario A. He�rero <br /> COMPANY AND TITLE COMPANY AND TITLE <br /> DDSM Consulting, LLC <br /> �{'Li V�.i.u: �i�l,�- �t-' �L�.�:,�� e' .�� <br /> ADDRESS ADDRESS <br /> ��.� c�d � Y �� Z� <br /> 14359 Miramar Pkwy #327 <br /> CITY, STATE, ZIP CITY, STATE, ZIP <br /> �` �/�h1�j( t �,,�j� �( � Miramar, Florida 33027 <br /> ��-k - 3o s- ir3 � �z�`( <br /> TELEPHONE F-,�dC' TELEPHONE <br /> �iC�.Y�' Z - Cl � � �� �� ' �f `fC) v FAX <br /> PART 4: PROJECT INFORMATION <br /> A. Name of project, including phase if applicable: Adanved Auto Parts Parkin� Lot Safetv <br /> Imqrovements <br /> B. Is this application for part of a multi-phase project? ❑ yes ■ no <br /> C. Total applicant-owned area contiguous to the project: 0.48 acres <br /> D. Total project area for which a permit is sought: 0.48 acres <br /> E. Total impervious area for which a permit is sought: 0.48 acres (including pond sites) <br /> F. Total area (metric equivalent for federally funded projects) of work in, on, or over wetlands or <br /> other surface waters: acres or square feet ( hectares or square meters) <br /> G Total number of new boat slips proposed: None <br /> FORM 547.27/ERP(8-94)A Page 2 of 5 <br />