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8/30/2017 10: 12 AM FROM: 8139869101 TO: +18137800021 P. 4 <br /> �0!U E Irk <br /> Site Prep 0 Earth Moving <br /> Undargraund Utilities 0 IN Clearing <br /> E Excavation jCD1 to Paving <br /> N$Ie <br /> !.ic.#COC1224107 <br /> 2A-G- ENT'AUTHORIZXTION, FORM <br /> PMW <br /> ALL lNP_0_W_*'n0N IS TO W WPM-OR LgGIBLY PRINTED <br /> (Contractors Nme) NOT COMPANY NAME (Contractor's License No.) <br /> hereby authorize the following to act as my agent(s) in obtaining permits for the City of Zephyrhills. <br /> Name of&Wnt Driver's License No. <br /> v�Ant�� ES N ECG or,13 <br /> 'T#�ian#�rria:sa��er.�e� a��:pt��aus�ty..��i�iimii�edl:f�tber�s��=ae�t�ior�zal�on, <br /> Tit .' t ita>i i `a irili:t ritaiiit ^+I� �t i#Ii STATE OF rLCI !c&=_ <br /> "nimfled iin vi►ritiha' bite und&W§h <br /> Irc�anse hOid@II'. COUNTY OF 4t(ls- �c cc; <br /> Sworn to (or afrlrtned) and subscribed before me this <br /> ,.c,.:,T.._, day of t t�Jc.(Z, �. 2017 <br /> ( edrrypas!name or LfcBMW r:otdv MaIdog 13tatemaai) <br /> License tiolder'S.Skpature <br /> NOTARY PQBf. C � .7 <br /> KRISTIN HAMILTON <br /> : •..7u{; <br /> MY COMMISSION 9 FF987762 sipnxtu:a or o ry; <br /> iN EXPIRES May 01.2020 <br /> tool>st=aa�ss PtorM2NoteYssnice.mm Personally Known <br /> 14338 N US HWY 301. Thonotosassa, FL 33S92 <br /> P(813)986-2901 F(813)986-9101 <br /> www.completedevelopment.com <br />