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<br />PATRIOTIC FIREWORKS INC. <br />DBA: RON'S HALLOWEEN <br /> <br />Date: ~~~~- <br /> <br />Promissory . <br /> <br />I <br />./ <br /> <br />I <br /> <br />f <br /> <br />I (Print)/ I ~ 6/1;:;: ~t5(l,-X/ <br /> <br />, (SignatuI / <br /> <br /> <br />give permission to Patriotic Fireworks Inc. to put a <br /> <br />Port-A-John aBII II itOA_e_ P"d on my Property located at: <br />~~c.t=:c- (P ~ / (-;L(" -;2..I-O'c>I'O-OC/fJ-o'o--c-o ~ 0 <br />. Street: 3> 8-C?' ~ 0 /.> 774- ~ j, <br /> <br />City: 2.e ~ (.-I Y /\. 1'7-/ Lc.-.J' Fc-_ <br /> <br />County: ;d If- S c.C) <br /> <br />State: Fe-_ <br /> <br />'- <br /> <br />Zip: J"3 >' '-f;2 <br />- <br /> <br />From (Date) JL..r A-/ ~ Ad (Date) ~ c.... r /' - c ,S <br /> <br />.J~~7/~a'~ <br />/1 ~l/4 d,:;( r~ V <br />c 1"\ 7 1/ ':J ~ <br />~ .~ - /~ .pI,?J ,C: ~//? <br />U.. /.~ _Jf._ <br />.;/ '-:.: / C1..~ rVV"~ <br />/A-~~V' <br /> <br />Q BErnE C. JOHNSON <br />MY COMMISSION # 00332616 <br />EXPIRES: SqIlcInba" 16.2008 <br />I-IOO-J-NOTAI!.Y FI. NoIary DioaJnt_ Co. <br /> <br />1314 SOUTH HIGH SCHOOL RD - INDIANAPOLIS, IN - 46241 <br />PHONE: (317) 381-0529 -PAX: (317) 381-0530 <br />