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JOHNSON'S EXCAVATION & SERVICES, INC. <br /> SIGNATURE AUTHORITY FORM-FOR THE <br /> PURPOSE OF OBTAINING PERMITS <br /> City of Zephyrhills <br /> I, Donathan A. Johnson, President of Johnson's Excavation & Services, Inc. do <br /> hereby designate the following individual (s) as having the authority to sign and-submit <br /> applications and related documents for the purpose of obtaining any permits under my <br /> State Contractor's .License, reference #CBC059540 for Johnson's Excavation & <br /> Services, Inc. I further acknowledge and accept as a licensed contractor, my <br /> responsibility and liability for each project permitted under the authority designated on <br /> this form, and that my failure to assume and fulfill said-duty may be grounds for the <br /> initiation of disciplinary action against my contractor's license. <br /> (C ntra'c Signature) <br /> DESIGNATED SIGNERS: <br /> 1. Randy Borovich 3. Tom Hull <br /> 2. Robert Beach 4. Sean Givens <br /> To and subscribed before me this 03 <br /> day of June.2019. <br /> CHRISTINABRASWELLRUPP ^ <br /> � * My COMMISSION#GG 1 j <br /> EXPIRES:J,aWY 10-2022 (Notary Public) <br /> Gn^+wThNH��7�U11dB(Y�RI��Ib <br /> (11�ls O Is not personally known to me. <br /> 1706 East Trapnell Road . Plant City 33566 . (813) 752-7097 . Fax(813) 719-9052 <br /> License# CBC059540 email: sales(idescontractins.com <br /> \\JOHNSONSERVER\everyone\DEMOLITION\Lake County\AUTHORIzation <br /> FOR PERMIT everytime.doc <br />