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• <br /> TO Whom It May Concern: <br /> �j671._ / /{� , give the <br /> ( License Holder Name) <br /> Following i = 'vidual(s) authorization to sign for and pick up permits issued to <br /> Lam/ by the City Of Zephyrhills. <br /> ( Name of Co .f'! y) <br /> Names of authorized individuals: <br /> n I <br /> l <br /> Sign - •• <br /> Date:(41 <br /> The foregoing instrument was acknowledged before me this A=3 day of <br /> del 2010. <br /> Notary Signature: . _ �i _ <br /> Notary Seal: <br /> + . <br /> MU NE MO NETT <br /> ffolny iwl -- f11Mo of f�llNlo <br /> '� S �' • � MP�M�n EglwtM�r /1, <br /> Candoo oa # DO T: <br /> eatifrnhooOffolauffloory <br />