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dm milwimisp <br /> 7981 Mainline Pkwy <br /> Fort , FI, 33912 <br /> gszakAol (239)- 936 -9154 <br /> Far (239)- 936 -2899 <br /> M ILL CORPORATIO Cell (239)325 -7371 <br /> CGC019632 E -Mail: jim4 ussignandnull. coin <br /> Date: R 12,1 ICJ k- . 7iy ;' c yk.,,0 "s 4_, i. c <br /> 362 5 4 0 1 1 c' A L.t,, r <br /> I, . Beckkrtet.r. , Owner /Agent of 7/1 -�4, 33 G /% 201- <br /> , <br /> Authorize US Sign & Mill to permit and install signage at: L,L' /z'c [ .S' ri,4111 c <br /> (Street) 7 7 gd 'S 30 I , (City / State) 247)/4 yx. u, ?c,..4 f , <br /> (Unit # if applicable) . <br /> Sincerely, <br /> : <br /> Owner / A ent <br /> e <br /> i i . IAI .. ACiA SEAL <br /> Notary Public Signature • <br /> County 14411s10 youti, . <br /> , „.10: 4f,„ CAROL SMIDDY <br /> ` <br /> '' 4+ N otary Public - State of Florida <br /> State of Mrco <br /> �wr �o�� P �; $ Commission # OD 703271 <br /> , u Bonded Through National Notary Assn. <br /> My Commission Expires 9 t 3 It <br /> In today's "hurry up world ", please upon completion, fax back to me, then _mail or __fed -ex, or <br /> _arrange for pick up, to the above address or telephone numbers. <br /> Thank you <br /> Jim Giesecke <br /> Permit Division <br />