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�Florida Medical Clinic <br /> Parcel ID# fj/L- �- 21—Q�IC�-02�1��—��1/U <br /> Address (p��� (D9,�`t' (�'��, le�l U(� . <br /> Z�,�hur ,� s . F�. ����Z . <br /> To whom it may concern: <br /> As the owner of the above referenced property,I hereby authorize Gillette Sign&Lighting to <br /> apply for permits and to install signage at this property. <br /> Owners Signature Owner <br /> r <br /> , ��` G�,�— � �� � I S� <br /> � <br /> Print Owners Name Owners address <br /> 5� Nc �t �-�� <br /> G (� �� �(2L�1'l�t S'�-Prc?°9� I ��o g' ���Jcf �Il�t�n�l�t 0 <br /> M �r�(xG�� � �1I�2 , �- � ��� - <br /> Owners City/State/Zip code <br /> �1�-�1�0 - �`l�l� <br /> Owners Telephone Number <br /> ' Sworn to and subscribe before me this�day of "� , 2015 <br /> ��c��,�- ���- <br /> ,,�\I�v P����� <br /> a� �; PAMELA GOULD <br /> Notary Public ;. .= N�ary Public•State of Florida <br /> r="M$r Comm.Expfre8 M�y 14,2016 <br /> r'��,o��t�.•� Ccmmt��bn+�EE 198300 <br /> �Ci,���`.. ������ <br /> Print Notary's Name Notary Sea1 <br />