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: . � <br /> ' POWEI2 OF ATTORNEY <br /> Date: � � r r <br /> t hereby name and appoinf [�'V� l/� �,li�� <br /> o€ �.,US f4c.���v� � #o be my Iawfui aftomey-in-fiact to <br /> act for me, and apply to the Division of Bui! ing Safety for a �����n��1 permit <br /> for work to be per€ormed at a location descri ed as: <br /> Parcel ID#:Section Township Range Subdivision BIbGIC! � � Lot ��'l to - <br /> (15 Oigit Patcet Number} <br /> Subdivision Name: <br /> Owner of Property: o j�',r� � �--� �,.�L�,. <br /> Project Address: �+�7 l �f <br /> c�ty: l ������zp c a�: �3s�z� <br /> �G� <br /> and to sign my name and do all things neces ary to this appointment. <br /> o G�/. f� -,�5 �-�� �.�� ;� � �n, � l G4�.-18'r��Z.s� <br /> {Contra ar me Type or rint {Ccrntractor's License Number) <br /> � <br /> (Contractor Signatzire} <br /> The foregoing instrument was acl�owledged befo e me this��day o£_�� <br /> of 20�,by 0 <br /> who is personatly kziawn to me or who produced ^' <br /> as identification and who did noC take an oath. <br /> A�t(�w"'�OY►�t' Seal <br /> Natary u lic{Print naine) <br /> Nota'1�u ic(Signature) iii�,,,,��,,,�i <br /> .tiN'��••,,� . <br /> Rev 43J33193 =� � ��G��'���� <br /> _• . ��*ry Pubtic..SUIe af Flofld� <br /> :�'yff �,�r�My Calnm.E�tplres Dec 12,201 i <br /> %a.°;;,...� Commts:icn t.FF OZ63t� <br />