# Instructions - Joint Application Section A, Part 3

A. Owner(s) of Land

Fill out this section with the landowner's information.

Name: Last name, First name, Middle initial. If the owner is a company or other entity, give the name of the person to whose attention any correspondence should be sent and include the company information under "Title and Company" below.

Title and Company: if applicable, enter the title of the individual named above, and the name of the corporation or agency using the following formats:

- Corporation - use the complete name of the corporation, limited partnership, or other association, as registered with the Department of State. Do not abbreviate, unless the name is registered abbreviated. Include all phrases such as "Co.", "Inc.", etc.
- Agency - use the example formats below if the owner is an agency of a State, Federal or local government:

- Corps of Engineers/Tampa Harbor
- USN/Naval Air Station, Pen.
- USAF/Patrick AFB
- DOT/State Project No.
- DEP Parks and Recreation
- HRS Office of Entomology
- St. Johns River WMD Pinellas Co.
- Bd. Co. Comm. Broward Co.
- Utilities Div. Tampa, City of
- Lee Co. DOT
- FWC

Address: enter the street address (911 address) of the individual, corporation or agency.

City, State, Zip: enter the City, State and 9 digit zip code of the applicant. 9 digit zip codes can be found at the USPS zip code lookup web site.

Enter a telephone, fax number and email address.

- Important! Including an email address allows the Department to contact the parties more effectively and can help speed the permitting process.

B. Entity to Receive Permit (If Other than Owner)

Fill out this section for the person or entity who will receive or use the final permit. If the owner will receive and use the permit, leave this section blank.

Fill out this section in the same way as described in A above.

C. Agent Authorized to Secure Permit

An agent is any person or entity that has been given authority by the applicant to negotiate the details of the application, receive any correspondence regarding the permit, is responsible for submitting required information, and is authorized to receive a copy of the completed permit.

Fill out this section in the same way as described in A above.

D. Consultant (If Different from Agent)

Skip this section if the consultant has authority to negotiate the details of the permit, to submit required information, and to receive the permit for the applicant, and list the consultant as Agent in C above.

If the consultant does not have authority to negotiate or receive the permit, but is acting as an advisor, list them here.

Fill out this section in the same way as described in A above.