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5MR00FING <br /> i,7ie n q� <br /> A Dmsmn of 3MG SOLUTIONS LLC <br /> I hereby authorize CArL-�o :jUr,-JQV&( —of 3MG ROOFING to sign/pickup on <br /> my behalf the permit for 615'a /0A S+ <br /> PRINT NAME DAV 1r.":� CJ4Ar0"0Le=z <br /> SIGN NAME <br /> ----------------------------------------------------------------------- <br /> State of Florida <br /> County of k <br /> Signed and sworn to (or affirmed) before me on (lay a-t <br /> Date <br /> b G4PAJ,3le2 <br /> Printed name(s)of individual(s)malting statement <br /> who proved to me on the baisis of satisfactory evidence to be the person(s) <br /> who app ed before me. <br /> Personally Known <br /> Produced indentification <br /> Ty ed of ID <br /> E <br /> i!MY Fubbe Staled Honda <br /> Signature of notary p_ Air. CWWren L Burgos <br /> Z MY Cpteansssiorr GG 237221 <br /> %:X'j tcxpi 0rTdn1J2D?2 <br /> 11.)�r0ons. <br /> (Name of notaryed,typed,stamped or printed <br /> My comission expires: ®1 ZOZZ <br /> 1850 W Fairbanks Ave,Suite B 407-420-0201 Info@3MGRoofing.com <br /> Winter Park,FL 32789 407-214-7549 3MGRoofing corn <br />