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17-18073
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2017
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17-18073
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Last modified
8/1/2017 11:16:34 AM
Creation date
8/1/2017 11:16:33 AM
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Building Department
Company Name
SLEEPY HOLLOW MH SUB DIV
Building Department - Doc Type
Permit
Permit #
17-18073
Building Department - Name
SHAW,WILLIAM
Address
38645 WINDFLOWER AVE
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i . <br /> i <br /> � � <br /> � <br /> � , <br /> � <br /> ' ��I�fVi OF INDIVIDUAL ACKNOWLEDGMENT <br /> I s ' <br /> � `. <br /> � Commonwealth of Pennsylvania <br /> County of Bradford � <br /> I � •- - <br /> 19 D c r <br /> On this, the day of e embe � 20 16 ,✓before me <br /> �eslie Fassett , the undersigned officer, personally <br /> appeared William S Shaw <br /> i <br /> � <br />' ' X , known to me (or satisfactorily proven) to be the person— whose <br />' name �S subscribed to the within instrument, and acknowledged <br /> that � he— executed the same for the purposes therein contained. <br /> � In witness whereof, I hereunto set my hand and official seal. <br /> I <br /> � <br /> I <br /> ,�?l� - <br /> i G <br /> i Notar}� Public <br /> COMMONWEALTH OF PENNSYLVANIA <br /> t�otarial Seal <br /> Leslie Fassett, Netary Public <br /> Monroe Boro, Bradford County <br /> My Commission Expires Oct. 31, 2017 <br /> �{;tt5ER,vElINSYLYFNU ASSOC1ATi9H OF NOTARIES <br /> I <br /> � <br /> I �`r`";... <br /> � ��� . PAN-1 (12/05) <br /> ��,�� . . m a <br /> � �N._�.: Phone:412-281-0678•Fax:412-281-0321 •Web site:www.notary.org•E-mail:pan@ermunro.com <br /> I <br /> i <br /> I ' <br />
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