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PERMIT EXPIRES 6 MONTHS AFTER ISSUE DATE PERMIT# PERMIT ISSUE DATE TIMBER OPERATloNS PERMIT WASHINGTON COUNTY PERMIT EXPIRATION DATE BOND HOLDER/CO. POSTING BOND BOND EXPIRATION DATE MAILING ADDRESS AMOUNT OF BOND $5000.00 PHYSICAL ADDRESS OFFICE PHONE MOBILE PHONE CONTACT PERSON 0F COMPANY POSTING BOND TIMBER HARVESTER MAILING ADDRESS PHYSICAL ADDRESS OFFICE PHONE MOBILE PHONE CONTACT PERSON ON SITE TRUCKING COMPANY(S) AS SHOWN ON TRUCKS-LIST ALL COMPANIES: OWNER 0F PROPERTY ADDRESS LOCATloN OF TRACT TO BE HARVESTED MAP & PARCEL # OF TRACT # ACRES HARVESTED ROUTE COUNTY, STATE OR FEDERAL ROAD TO BE USED AS ACCESS TO AND FROM PROPERTY. THIS ROUTE IS TO BE USED FOR LOADED TRUCKS AND UNLOADED TRUCKS UNLESS SPECIFICALLY NOTED. (ACTUAL ROUTE WILL BE DETERMINED BY WACO.) PROJECTED START DATE OF TIMBER HARVESTING PERMIT HOLDER/APPLICANT (PRINT NAME) SIGNATURE ``BY SIGNING THIS APPPLICATION, PERMIT HOLDER ACKNOWLEDGES TAT HE/SHE IS RESPONSIBLE FOR FULL COMPLIANCE WITH ALL CONDITloNS OF THIS PERMIT, AND IS FURTHER RESPONSIBLE FOR ANY VIOLATIONS BY ALL WORKERS, LOGGERS, TRUCKERS, HARVESTERS, ETC. OF THE CONDITIONS OF THIS PERMIT. SAID PERMIT HOLDER IS ALSO AWARE OF POSSIBLE FINES AND FINANCIAL RESPONSIBILITIES FOR VIOLATIONS OF THIS ORDINANCE."