|
334�528439 AES Mechanicat 07:55:26 a.m. 08-15-201A 911�
<br /> � w • , � �G�dC �C11n"�
<br /> ' � - ���
<br /> � lillillillllllllf11il1�lli1�1111illlllllf1i1�111i111111i1f
<br /> �������
<br /> Ropl,:1620527 Reo: 10.@0
<br /> DS: 0..00 IT: P�,00
<br /> NU� CE�OFC , � � •�8l04I14 T. S�ine, Dpf.y C�erk
<br /> �..y..____._._..,_.____,---_.._.,_....._..____....---_..__..._._. ,
<br /> ' r�pt11.A S.p'NEIL,Ph,D.P�1SC0 CLEitK � COMPTROILER
<br /> ' 08l04J34 1 s43 �+ # af+�3 q
<br /> FeanttNo. � OR BK ���i.� PG .7�.�'!
<br /> Piopcdy[dcrt#iPcationNo.��� � v�� t}�{� Q� ._._._._..__._._...
<br /> THfi UNCIERSIGNBf?harrby give infuim�you 1h�t�Ha' t+vil!bemadtla aei«ninareet P�P�Y.�.fis�tt3ance with
<br /> Ssctiols 913.i3 of tho Ftneids SCstuws,the{6ltowiag intu7mation k vIdad m diis PUTJCE OF CQMf11ENC61VIElV7',
<br /> I.I3ESCiIjNJ4D4�I�I��YU?B�fIC3GI�JNOqC� [�t�C a�� -� .11-�i�v�'� p,pl�i�rh����.
<br /> �}sa�naa�ss;
<br /> 2:Uottanl desulptlon ofimprovemencx
<br /> 3.{�wntr IAform;atiom
<br /> a���o�►a�aa���:..�„ f�'n� �� 1�,�Ir� Y�a� �ee�r�hetd,1 C.{dX11.�
<br /> b}HainaandaddtesspffEcs ititehgtder(ifoWartt�Ya�ecj
<br /> c)teoerest In proPa�tY . _ _
<br /> 4.Cnnuuc�+sc3afamtatian .. . ,
<br /> a�N��r�a,� �S rr+�chcv�,�±��l.�� �`D�&�cc.`l�Et���"� Z'"�lla,�c�,,,�.�'
<br /> b)Te}cphone No,s� ;,,2 0 ,�,_Faz Na(OPti)...�:���—�.--
<br /> S.Snn�.y.Lifotmat�on �
<br /> a)NAme.enil�ddra�a:: •
<br /> b)Amcuuc 6f Doudi•_�___,,,._...^.
<br /> c)'Celeghnna Na:: Fe�c•Na�f?nt.} ''
<br /> b�[Rader .
<br /> a}Nasneaad eddros4:
<br /> � Fboce Nb.
<br /> fi.Idca�tity afparson wid,in fhe Sfata af Ftarida desiG¢�t�bY axnler upoe!wbom riottc+cs Q"r othar doaainarili myybo servak
<br /> a}Nacsoandaddte� ^---- (. .
<br /> b)7tlqpKonoNo,:,,,_„ . . � FexNo.(pptj .
<br /> S.ia addlt£btt to himsel�'owi+ac�dess`gaa�s slsa t'oEiai'viagpeison w rudi a capy of;ho Llenor'a Natsoe as.�ir"avSded�n S�etiaa
<br /> 713.I�G17(b),.Plnfide Stazufoea:
<br /> a)Wune eod addte�:
<br /> b�Tsle�ihocm No.: 4 ' FertNa.(Q}r[.} . . . �
<br /> S.Ezpirstion datc oiN'odca af Ca�rimencemeut.(thc axpiration dat�!!o e year 6iq�tthc'dero of raeordin�untesa�diBet�.stacn Lt
<br /> siwcffird):
<br /> WARM[44"c TO'OWl�i�lt:•A�II'�P`AYM6N'T5 Mi1D'&8Y THE O A�'7E�'!'liF.�}C�A.TiQP101r TEi�NOTfCE 4F
<br /> COMN!$NC'EMI�'AR$CQIVSTDEt2E4 tMt'ROI'�R�PAY 3 TJHD$Tt C�iAF'�'EA.'71��PArtt'i'i�6ECTIOJY 713:f'3�r
<br /> I�7.CyIt�DAaSTA'fUTES,!!Np�.UY�F5lTLT7N'YOURPAYI[+IG. IGE.FOR IMPRQVEMENT51'U YOURP�tOYBRTY.
<br /> A NOTICL l3F�COMM�N'CEKiEIPf MU�'I'�B RECbW1ED' P033BD O1�TH8 JOB 6[�"�,HBFOR�'�'�,;E7RST
<br /> INSP$Cl7QN.l�►YOU 1T17'�NII TO QSTAIIYY FIIV�Cti�tGr SUL1`Ytl[11t,I,EIBD�7t OR A2d�A1T+ORNLY$BFOA�+'
<br /> COMMFIVCING VYO�tK QR R�+C¢RDiNO"SfSyXfR Pt0?IC�Q8 COM1MlEN .
<br /> 9!"A'►'C;!QF P1.OR1l1A
<br /> Cb1P.Y1'Y QP4A$CA •I .
<br /> 3 h�Ca Qsma's Aut�cd�ed0
<br /> �x� ti.S�� .
<br /> f i ent wus�clmawi bcfam �aey ti�jt;�„�:_.._._._r 2�,�,,bY
<br /> � as� . of e. .officar uus!
<br /> (�Ypa awhoritiY,� B . �,��Y
<br /> in fucc}fot'' � name ofputy "behalf whout' t.
<br /> FcrsonallylCnown_,,,�,ORProduccdldattific�rciori„_,,, Notazy i ' '"`'
<br /> i��oM�rc���, �
<br /> Type of IdeutifKation Frodueed t�tatae `t) • �C��� A7E OF ILW�lQJS
<br /> E�lRFS�f9J03M8
<br /> Vedfisx�on pitraaaat ta Sectian 92.523,i�arida Stafutra:ESaderpenatNcs f perjury.i decisre thst i:lmve sesd tho rcgo
<br /> the feets neted tn it ate truo W the hest of my�owladge end 6eltef.
<br /> SipNnttt fHtluntFqsOnSi�ingALOra
<br /> F4AMMqCfiwIIm7 ,
<br /> . �
<br />
|