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JAN 07 1996 04:15 FR TO 2698432 P.01 /01 <br /> , <br /> tkofigNi DATE ri <br /> I 2 % GIVE PERMISSION TO: <br /> UNIVERSE NOVELTY & FIREWORKS COMPANY, INC. <br /> POST OFFICE BOX 1862 <br /> RIVERVIEW, FLORIDA 33568 <br /> (813) 677 -1874 <br /> TO SET UP AND OPERATE A TEMPORARY STAND ON MY PROPERTY <br /> LOCATED AT: <br /> 5935 GALL BLVD <br /> ZEPHYRHILLS <br /> T DECEMBER 10 2009 TO; JANUARY 2 2010 <br /> LOT # <br /> BLOCK # <br /> SUBDIVISION # <br /> OWNER/AGENT SIGNATURE <br /> STATE OF FLORIDA <br /> COUNTY OF HILLSBOROUGH <br /> SWORN TO AND SUBSCRIBED BEFORE ME THIS 0 . DAY <br /> OF , 2Q , BY k70)►q G r c r `. 0 IS PERSONALLY <br /> 41310N6► R HAS PRODUCED W AS IDENTIFICATION. <br /> yr 4 t <br /> PATMCIA ANN 1010111 I OTARY <br /> I t My Cam EIONT MI 21 . MS <br /> CMNIefl • DO MN <br /> OMINI Mr.. WOW *MY AIMIL <br /> ** TOTAL PRGE.01 ** <br />