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I certify under penalty of perjury that I am (check one ) : <br /> QLegal Owner (s ) (All owners must sign as their names appear on the <br /> deed. ) , <br /> aCorporate Officer (s ) empowered to sign for the corporation, <br /> �--J Owner 's legal agent having Power of Attorney for this action (a <br /> notarized Power of Attorney document must accompany the <br /> application ) , <br /> :and a the foregoi g is true and correct . <br /> (Sig ure ) (Date ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> t <br /> i <br /> E <br /> Quarry Excavation - 14 - ( 7/84 ) <br />