0210112007 THU 11:33 FA� - _.. • -. .. -
<br /> Q002
<br /> oil /
<br /> �7,
<br /> 5 n JOmqu&t Courcy Z:nv(nxtm:�ntul Hz. tYF Qepx�tmznt th-A 1V WIPAI f anon.Alzpfirs km"_ept,t9lrwna I
<br /> JCFHADDRESS•._/�� ._ wr{�f}glT cRm:
<br /> LICENSED C€ NTRACI ORO DECFAP,Et'PION Cts
<br /> I heletty at5ftnt ,%I pat licensod uttdorHie prautsiotIs 11(:hapfar o( N me ussrg with kie t n 7G 1)of ihvistpit
<br /> 3 of the Probt rii as Code and my ficanar i s in full fair.,wldjffexm
<br /> Gait r
<br /> r
<br /> t'nntTd nataw:
<br /> tRO\KE_r2S' Ct'lMPENSAT, !-tht RTtC7t3
<br /> 1 t�n.by atfsrrt vaetsr pnhatty of PEejury cme of tl,a fotbwi:rg 6rc:tar.4bons: (C#- MK ONE..)
<br /> _ t fcai'e anu!wilt nt�tirn'Li+R q cwatifEc c at cr MA3� 1t to:5W Intuns roe AtAei c'rr mpansabon,a::provtdetc;fur
<br /> by;;ed ran 3713D ni'thc Latror G'ax}e, fru L'ar.pt'*.wnranv,;I 0tr work torwttic+,Th42 pomp o isuacd
<br /> I have and wil!aiia'it mn wo Xeta cre<Ttponst 5 nn incur, pr^ss required by teMbon 3`ta0 of ttte l-mw Code,
<br /> foe(he,p-dommnca of ffl,nroric nx wtildi thta}l0trnii.i€is€vtvf. h4Y r,rodcr-rs'mmpaneal:sn i.tsurnnce j
<br /> camerrnQl,C+{icynu fe�lyaiyc� '� r ,,
<br /> Carf#er. ' n _tli-_t�. .. .:__®..r Polity Uu &-r:t f V[ ® .d-Q,°. `
<br /> I cr"fy that in tb.^jti:domtar>w of the wade fni Wh}dt this.petaiit is issued,t shalt im'.Gap4y any person fn
<br /> tarty ir+;tfttterxo a:to DaDXW nubjuct tq the Wc4*eta'eanTjat7.lt,atiara law:of Cskfua%i:a,and agree that III
<br /> s.h«utd be---ww svtdect to thc+worcerc'contpen::aj-on pmviaans 4800"n 3700 ui th,:i atnx Cattle,f•ah.ill
<br /> fu t of ( p{n ig n-I
<br /> [aat<:: 5ign:+tarn.
<br /> f'rintty-t tiatne: 1�
<br /> YtAFitf WG:P,v1,Ut`:t3 T!)SC;OfiRk W04iK[R:`,'r;Up1PEPt3hTit1N r:VYE[tAGF.Is Ut LMAWt-Vi-,AN03NAL!3U6Jr'C1
<br /> A4 MPI OYER TV C7tA:GNAL a WALY185hrtt)CIVIL Ktt`rL:T:uP TO©3Jsr KVtdO:tF`.t71'9tOtrL.,^,ttU[SOEkkRS
<br /> (fitU9,000.t,1N kotafTlCMt 7rt Ttt�CVST OF[X7rdar^Cft`;ATtVN,tRGS'{,At'r!OF:ff[Y'=t F6E5: .'�.t:ra!}tiP3hG Cv A: t
<br /> Ff:VV&tF6t F[Ttt fi+!u£C:7i)t:Yfn6 Ot"7ttE LhSt}R C[?CTC,
<br /> = TfaU FOR ?:t,�'RTHAN C-.57 SIGHING PERMIT APPT iCATIONS
<br /> t•. ���. y `""�_.� ._. .. _. is+tgttasunt oto-,/Granrra+:tauit+nrrz d ;:+,y';a=:tar'tt7.p
<br /> � r, a e:.,r.,. '.., ,r.rn,,,1 s vtpt+N6t:fFP"fri:f r",n'�':{!i'+4+, n«atr i.Vrri@ 1+:ntluY. a. , •Y,,. .:i•.....•.. . .:-r
<br /> i
<br /> , , tae.•,.- .. , ., .;a•- .4r.. .. + ,..r'. o-. ,tat:.,,. ... 4
<br />
|