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Florida Medical Clinic <br /> Parcel ID # � - ��-�J -(� p � - p 0 - 00�0 <br /> Address � R` /� _/ �►iv D �1 vn. 7�'pt,�Y-�°�hlr�Ll.S, �L <br /> To whom it may concern: <br /> As the owner of the above referenced property, I hereby authorize CB <br /> Sign Service to apply for permits and to install signage at this property. <br /> Owners Signature Owner <br /> llerr� �,c. {� �� 3 s rvv�.. r�f -u�� <br /> Print Owner's Name Owners a dress <br /> �-,'l�S� 1� 3 3 S�l Z. <br /> Owner's ity/State/Zip Code <br /> g(3 ��l�- � 7� �-1 <br /> Owner's Telephone Number <br /> Sworn to and subscribed before me this /y� day of ,2013 <br /> �a�' � ` '�� <br /> N�t`� Pubil�•i A�:�5it1` kL�dIN A.MIeH€3fiHUR <br /> �'���: NUTARY PUBUC <br /> �� -�STATE OF FLORIDA <br /> '� , Comm#EE155651 <br /> Expires 12/26/2015 <br /> _�A6 i n � �N�4,-�4,� ,- <br /> Print Notary's Name Notary Seal <br />