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'" " $ 1315 Hobbs St <br /> � ��� Tampa, Fl 33619 <br /> [leatin�;8 t:npl�ng Ph: (813)657-8818 <br /> '�'���f�" Fax:(813)657-6378 <br /> �u�.ncnc�s�assa <br /> 5/1/2017 <br /> Permit Agent Authorization Form <br /> I, Christopher Kent Myers , CAC1813893 <br /> Hereby authorize the foliowing to act as my Agent(s) in obtaining permifis in the <br /> City of Zephyrhills. <br /> Ruth Mason Myers DL# M620-773-55-526-0 <br /> This form Supersedes any previously submitted letter(s) of authorization. <br /> This authorization will remain.in effect until cancelled in efFect by the <br /> undersigned license holder. _-� --- <br /> ' �,,.�� _ <br /> <�- <br /> ense Holder's Si re � <br /> State of �1�,�, � � <br /> " County of��,11 S 1-��Q, ; �, <br /> Sworn to (or affirmed an� subscribed before me this <br /> � n d , day of I`�1�; �/ , 2017 <br /> By Chris Myers <br /> Nota, Public �. <br /> � <br /> Signature ` <br /> My Commission expries: ��� o � �L `� <br /> Personally Known R Produced Identification <br /> F���i c��'� Vr�v-Q-<S �i c.P..r��� <br /> Type of ID Produced. � <br /> ��1/r plp� � <br /> �.?o�'" "�� SELENA JOMES <br /> _ Natary Publtc-St�t�ot floMd� <br /> �'o�a��n���, My ComiA.Expins Aup 20,�019 <br />