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, � <br /> I�urt llen <br /> 209 S Fron age Road <br /> Plant City, FI, 33563 <br /> July 31, 2014 <br /> Contractor Au horized Form <br /> City of Zephyrhills County Contractor ID <br /> State Certified License #IH1025140 <br /> Qualifiers Name Kurt Allen <br /> Business Name Kurt Allen <br /> I authorize the following individuals to si for and obtain permits. <br /> THIS AUTHORIZATION S ERSEDES ALL PREVIOU5 <br /> SUBMITTED AU HORIZATIONS <br /> Nancy Armstrong <br /> Sean Swonger <br /> Sandra Cannon <br /> Carol Creech <br /> Sirio Ramirez <br /> Kitina Bloom <br /> Steven Bell <br /> Mark Dixon <br /> Signature of Qualifier: <br /> �... <br /> � <br /> State of County o _ S om to and ubsc 'bed before this <br /> dy � � O � <br /> S�gna (�Il �j,� <br /> Notary Stamp here <br /> �1p0.Y PUB�i SAYVDY CANNON <br /> � ;"••, o <br /> * * MY GOMMISSION#EE 868540 <br /> EXPIRES:January 27,2017 <br /> �r�tFOF F���\or Bonded Thm Budget Notary ServKes <br />