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1 <br /> Dear Florida Medical Clinic: <br /> This letter is required in order for SIGNSTAR a Division of West Central Signs to apply <br /> for permits to install signs at your location. It needs to be signed by an officer (or <br /> owner) of your company and has to be notarized. SIGNSTAR a Division of West Central <br /> Signs must have the original to be submitted with permit application. Thank you. <br /> Property Owner Authorization Form for Sign permit Applications <br /> I, �bE �'�L�-TD Q'�-� , properly owner or agent of <br /> properly addressed at 6606 Stadium Dr. Zephyrhills, FL do hereby give permission to <br /> SIGNSTAR a Division of West Central Signs or its agent to erect a sign at the above <br /> location. <br /> ��Q. \J�1 C1. \U '(�'r� ParCel ID # 02-26-21-001 B-00000-0010 <br /> Property Owner (Please Type or Print) <br /> Date �b � Zc� I S� <br />' Sign ure o Property Owner or Agent <br /> `� $ � 3� �arke�- SQu,u.re. , Z�. �h•�rh�il�s, �� 335�}� <br />, Mailing Address <br /> �13- "1 �0 - �� '1� <br /> Telephone Number <br /> This instrument was acknowledged before me this 1�day of C,� e r , ��S <br /> ti���� �� <br /> Notary Public (Signature) <br /> `�Q'�+RYPV*��; PAMELAGOULD 1nnD I I1 <br /> r . . : Notary Public-State of Flor(da �� � � I l.1.G1 �Ul�`G <br /> ;�,,, o�;My Comm.Explres May 14,zo�s Nota Public Name Printed <br /> •,,OF F� .� Commission#EE 198300 ry <br /> '•.� oe. <br /> �nu�n�• <br /> Personally Known�/ <br /> Produced Identification <br /> TYPe: <br />