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10/22/1998 09:34 9167829054 DOULOS PAGE 03
<br /> 10-21-1995 2'.34PM FRO{-{ P. 2
<br /> +.. .., GREEN FORIiI
<br /> °ATE MASTER FILE RECORD IHFORMAnom "MFR"
<br /> UNIT IV
<br /> OWNER FILE
<br /> pwv[ETETHEFoLLo mmis;PROPERTY OWNER INFORMA77ON. o�10
<br /> Ccrar.� GINNER Gt+w,�t,tTcraw��etwTrEMD
<br /> MoNe
<br /> 140el 3� 1
<br /> o,ttttart mats
<br /> �ypr 4*
<br /> Sllattess"AMC
<br /> Owner ttonto Address[ OIJYlat's lAcirlsi 0
<br /> Bss.T♦ LP
<br /> owls mWd"mds.w - l 1 I/
<br /> Nallirm Address City j+ 1/V rip
<br /> AnOM I Y O rA IP
<br /> PACIUTY FILE
<br /> CoMPCEWTHEPMLOWIAW BUSINESS/FACILITY 1 SITE/NFoRrA770N,•
<br /> Is 01h NLW a manses L=ATMN not prsvimly rgalaited 11V Ow Ettvltlattaerrrtt►,HeALTM Drvtstatt 7 Vey C Ne Am
<br /> Is this an E�uamMa lausinoss Lao.noN tut a NOW TYPE Of r6GW8tsd Stasiness 7 Yea r-3 Na Am
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<br /> t4 7 s1rE Atmt�ss O 1 stwis s euswu.R3lo►tt j
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<br /> SIA"G zip
<br /> Cm Ci y., a reK e,�r;l+rtrtr7sq am r ''1, „RT ,� .a„1 1 Warr Al,
<br /> EtfC?�Ts."� itn �
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<br /> Mailing Address fD1FFERENT 01—A80-0lyAdOrdt" Ate 66n:or Cors Of IOPOOM9
<br /> Joe -Qldt�idg
<br /> MMUM9 Address City 5. West I.A S 'f' U n rd SIAM CA ZIP
<br /> r77
<br /> -A � 1' ' ti' ,', ,�� „�;:;+{ f.�'r'+�� ,. 'v..�A4. ;1: ;.!.!•t.Ir�•: ;;�s�1f^. .":c ;n.•:r.. ,. ., •
<br /> TM1RD P�RT1f BILLING tNfO: Gornp/Cte d Billing Patty is WayeroHt from Property Owner orFaeitity Operator ldpnbNed obotrltl
<br /> I ALbntian_arGfaro Of 0004W4Ml
<br /> Bmmixs ra
<br /> J e e
<br /> PgONi
<br /> MaJlirg Addr.ae
<br /> STATe Lr
<br /> cnY
<br /> for fits and charges CYltNER FACUTY/BUSINESS TwRD PARTY 84LUNG
<br /> a r1N �otq! tAXGr Ar. owUctY larn7; 1,lac undcnlYnod APplicaat•certit�flat 1 a.n dee Owrte.r,o pcFulur"or Artharfytd Agmmt of this Bttuoaa,and I aciteotritdp lllsr
<br /> and/or AFpUALr0fAIrGA1,Wjft thio oper+.Wa W-11 I.E:Ilad to Inc.t the addrve Identified show*ar the ACtY1l7Ml,lU�L+
<br /> IGNAi'6ia.Ptu,uLTISL 4'xrtirLiMLA'r CMA f9
<br /> ler this
<br /> 1440 Certify that 4,11 infortaatioa pru'ided oa!Mill wpplicatfon is true and eornarti and that all tc=ulated aRiv;tie�will qs pesferttttrl 113 auordaaee trips td aDl.11d.6ta
<br /> " An COuNry Ordinance rades und/or St*.Jerdt Nnd STATL madlor BLoswAt.Laws end Asdub.t:or.a As the utdesatprtad traraaY,aparatdr,Or t.n.l of theptopetty}oeatad at
<br /> ehd.s pcititrhite address, I hemby authorise the ralaa+le of any and all ra:alb and envlrosotased aoteottrrta,t ioforrtrtitrn is S'►W JQAQLJIN MINTY !NVIWUNMEKI
<br /> IiF,►LT"MVL%014 to soon a:It is aysil 1 sed st tele ams a—tt la Pr6v'dW to me or Iny reptatatltodve.
<br /> /-�i� � POINT
<br /> i StCiNATYRE
<br /> APPLICANT NAME J O 1^I q
<br /> DRIVER'S LICENSE s
<br /> TITLE C'_i/�I tDv–
<br /> ' 1^U^ / v \G.1/lo� �o..osrtnevrva
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