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04-3613
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04-3613
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Last modified
3/6/2009 3:21:53 PM
Creation date
2/8/2007 11:06:03 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
04-3613
Building Department - Name
KENNEDY,BETTY
Address
4912 19TH ST
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<br />Before me this _ day of <br />by <br /> <br />, 2CL- <br /> <br />(name of person acknowledged) <br />Dwho is personally known to me, or <br /> <br />Dwho has produced <br />(type <br />and whoD did 0 did not <br /> <br />of identification) <br />take an oath. <br /> <br />Signature of person taking acknowledgement <br /> <br />Name typed, printed or stamped <br /> <br /> <br />, L.V~ <br /> <br />(name of person acknowle ed) <br />[1ho is personally known to me, or <br /> <br />~~ who has produced r,( PJ.. k tier 07tr 91-,7760 <br />( ype of identification) <br />and ho Ddid (Z6. not, k(-~:J; <br /> <br /> <br />" <br />Signa~ure of person taking acknowledgment <br /> <br /> <br />Name ,~.~e~CdMM~~~~~~H~W"ed <br />" .~ Februory2~..~"~~~ur, ,> <br />
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