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PERMIT AGENT AUTHORIZATION FORM <br /> ALL INFORMATION IS TO BE TYPED OR LEGIBI,Y PRINTED <br /> I, Daniel Scott Howard Lic# CBC1253637, <br /> hereby authorize the following to act as my agent(s) in obtaining <br /> permits in the State of Florida. <br /> Name of Agent John J Sarna <br /> Driver's License No. 5650-470-58-420-0 State of Florida <br /> This letter supercedes any previously submitted <br /> letter { s ) of suthorization . <br /> This letter must contain only the people you want to pull permits <br /> in your name. To make changes to <br /> this letter, you must submit a new letter. This letter will <br /> delete and replace any previous authorization <br /> letter and the information contained thereon. <br /> This authorization �ill remain in effect until <br /> cancelled in �riting by the undersigned <br /> license holder. <br /> License Holder's Signature <br /> STATE OF N DY� C�� (�� I1 Qi <br /> COUNTY OF �� U�� v n <br /> Sworn to (or affirmed) a subscribed before me this <br /> �_, day of �l�.Y) �i , 20 � � <br /> by Daniel Scott Howard `` PG�ENSCEy'.,�� <br /> ;� ,�pR Y � <br /> _ <r O <br /> NOTARY PUBLIC =� Z �U Z � <br /> : Pu��' z: <br /> Signature of Notary �• ; J� <br /> . <br /> �' .qcKSON�;:�� <br /> Name of Notary Typed, Printed, or Stamped "" �' <br /> My Commission expire�: ��,(,�'1� ��, ?i�� � <br /> Personally Known ✓ OR Produced Identification <br /> 1 <br />