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1LMUT ED POWER OF ATT®I�IE�Y <br /> Date: l� ' �8 ' 6q <br /> I hereby name and appoint: � '7 S� �06 <br /> an agent of: Moam ev P n+v&,'r_ <br /> (Name of Company) <br /> to be my lawful-attorney-in-fact to act for me to apply for, receipt for, sign for and do all things <br /> necessary to this appointment for(check only one option): <br /> C� All permits and applications submitted by this contractor. <br /> ❑ The specific permit and application for worIc located at: <br /> (Street Address) <br /> Expiration Date for This Limited Power of Attorney: ', c) _ <br /> License Holder Name: <br /> State License Number: 6C C-)C -)-(.g <br /> Signature of License Holder: <br /> STATE OF FLORIDA <br /> COUNTY OF r <br /> The foregoing instrument was acknowledged before me this 1—day o <br /> 20 by �6Sc�n rJ n who i scan sown <br /> to me or o who has produced I as <br /> identification and who did(did not) <br /> �take an oath. <br /> Signature <br /> (Notary Seal) �12 L-° �J� 4C_S: <br /> Print or type name <br /> Op• Notary Public State of Florida Notary Public-State of� <br /> �a Heather L Bridgpes Commission No.�, 3� � <br /> My CamMiael®n j 320564 <br /> arn7fa0,'�3 My Commission Expires:4, , ' <br /> (Rev.3/27/07) <br />