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�. : . n <br /> FROM 4RAM GEOTECNiAL DRILLING INC. FAX NO. 2096233859 Jan. 32 2608 83:59PM P2 <br /> 1 �-.',u�-�^�►]C' :4� rny1aRC, ['JG. <br /> r <br /> S n SoogWn County CnAmmm atal HoARh Depyrbft t"reit iY We%Permit A PUD 3uPP*Wo*nt <br /> 9 <br /> JOB ADORES&11 00 c�^M i ' -_Q '. _ PERMIT SR*: i <br /> LICENSED CONTRACTORS DECLARATION CL W <br /> i <br /> I nereby a%w fi-t I arp ftanxeo urzor the pravioans of Chapter 9 mnrnenemo W"seftq',WM er orvwon <br /> r 3 d the:Bualnen and Profeesions Code am my fear+se Is in full fame and educt <br /> f Lieanse�: 9�: 36 <br /> /22!C <br /> jPrinted n1mv: FS3, Ll _.._._�.........� _ <br /> W0ft ERS'r:Cr[I PEt46ATION DECLARATION <br /> I hamby$Pf m xwz purity in w-ptfir 0.io of Me 11N.avAn9 doclaratiatrs, tCHECK ONE) <br /> EI have vr4 MRH mater Wn Y eartE Cafes,r cansent to setf4q>prae ScwwarK&W vAV@raesalons as pravMed for <br /> f by abon 37W*f the Lazar Corse.W s w Performance of the Acrk for which dei$wmd is"gd. <br /> r iia &jitj wg?mv;nrain►vo rkws'carnpsnssrt,on in*4)Aw e,a•rocLiWa4 by Secliw..3700 of we Utbar Code, <br /> s dor pwtormance of tali worst b_r which this pom%l ft 16wo4. My 6 <br /> [ an4.notx rsumdem are; <br /> I I+x My that[n the perfaimart:e d tie Aerk fat-vMiC11 40it p*Meie it$vied.I$nail not Mnpfoy AIM/person in <br /> s Im71 qonrter so sA ao oeoor:o cuboc't to tna workers'campen&jzdPn la*v of Colftmi;a.enq Done ISM If I <br /> • she Id is+carrle 6t12tjbL:tp t)ee:vth-lcrrs'�+x"O�sativn pravis'rarts Of BCGt+su 37D0 eel lha laraor Ct+de.I sflpir <br /> fa Q*M*'wlth moge Drofti na. <br /> �� <br /> I a '.m�Io—Stwwita- _.. <br /> i <br /> Printed Warne: . <br /> WAFUU PAILUOM TO SEG1 Z*VW4 IIta'QOM+QISik:ID*r DOVEAAOff tit i1M,IlWFL%w NO SK*U OU&PIGT <br /> wN X111 QYER M M M MAL PeXALYMS AND DWSL MES LIP TO AMIE HUNDRED Vk16t.' AWD DOUARB <br /> {sj ).pe ACDmow YO'fHrr c mTpF compowsAum,tN'mrsT.ATTORWrs.-KM ANG DrAM11OM AS <br /> PROV90P FOR Q SIG�T'TI ?17706 OF THE LMOt1'CODE. <br /> AUTHO IZATION f+OR 'T'HAN C-,57'810NI110 PERMT APPLICATION <br /> I. _ ,Iei,4r,a�re siC�67 ticeuract aulhorbua rrtre$entithel. I <br /> rerebv aii1ler4e&OWWt ro~ ' a AA hA._S <br /> t <br /> to sign iMW Sar.roaquln Course.!Well rwmit Applkwoos on my betott i undvsya�d tlrlyR■aayA++radon Is ws1+d Cor f <br /> one til year and W IUrs IM vo the wArK plan rM=W as the Poant page of Naw a oiamson. It! <br /> .Lim 2111 1m) <br /> 71'TAL P.Z2 <br /> o05-3DZ: <br />