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ORIA-revised 02/2020 Page 2 of 17 <br />Part 3–Authorized Agent or Contact <br />Person authorized to represent the applicant about the project. (Note: Authorized agent(s) must sign 11b of this <br />application.) [help] <br />3a. Name (Last, First, Middle) <br />Kopitov, Anna <br />3b. Organization (If applicable) <br />PND Engineers, Inc. <br />3c. Mailing Address (Street or PO Box) <br />1736 Fourth Avenue S, Suite A <br />3d. City, State, Zip <br />Seattle, WA 98134 <br />3e. Phone (1)3f. Phone (2)3g. Fax 3h. E-mail <br />206.624.1387 (o) 206.940.7068 © <br />Part 4–Property Owner(s) <br />Contact information for people or organizations owning the property(ies) where the project will occur. Consider both <br />upland and aquatic ownership because the upland owners may not own the adjacent aquatic land. [help] <br />☒Same as applicant. (Skip to Part 5.) <br />☐Repair or maintenance activities on existing rights-of-way or easements. (Skip to Part 5.) <br />☐There are multiple upland property owners. Complete the section below and fill out JARPA Attachment A for <br />each additional property owner. <br />☒Your project is on Department of Natural Resources (DNR)-managed aquatic lands. If you don’t know, contact <br />the DNR at (360) 902-1100 to determine aquatic land ownership. If yes, complete JARPA Attachment E to <br />apply for the Aquatic Use Authorization. <br />4a. Name (Last, First, Middle) <br />4b. Organization (If applicable) <br />4c. Mailing Address (Street or PO Box) <br />4d. City, State, Zip <br />4e. Phone (1)4f. Phone (2)4g. Fax 4h. E-mail <br />Fidalgo Marina Owners Association <br />3101 V Place <br />Anacortes, WA 98221 <br />richard.a.pilling@gmail.com360-299-0873