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i'. <br /> .l <br /> ,i :J <br /> lk �• <br /> PERMIT AGENT AUTHORIZATION LETTER <br /> ALL INFORMATION IS T.0 BE TYPED OR LEGIBLY PRINTED <br /> 1,2473wla ;E0D,RlfvFz lJ�1�33� , hereby <br /> (Contra or name) (Contractor license no.) <br /> authorize the foVoing to act as y gent(s) in obtairriog permits in Plant City, <br /> Florida for , G (Company name) <br /> :Name of Arit_, <br /> � ::� Drivers <br /> INITIAL YOUR CHOICE: <br /> This authorization expires one year from date of authorization <br /> This authorization will remain in effect unless revoked by the undersigned <br /> in writing <br /> This letter must contain only the people you want to pull permits in your name. <br /> To make changes, a new letter must be submitted. This letter will delete and <br /> replace any previous authorizations and the information contained therein. <br /> STATE OF j���(J� <br /> COUNTY OF � � bpk <br /> Sworn to/affirmed and subscribed before me this day of Dow& <br /> , 20_ <br /> Personally o R produced identification U /� <br /> ont tor's signature Notary Si EM. ODgiSdEZ <br /> Commission#FF 236803 <br /> June 3,2019 <br /> (Notary Seal) My commission expire o;� E icesB0048VW <br /> �,'r'''�+ ...,,••' a �r <br />