Laserfiche WebLink
�fPL]C�T.Q+ _.2 01.7:RQtO:7t."J ';�vr[ R<ZROt 7T_ O[lIf:NG 2FPAIR P£TnIT <br /> 73IS ?E.Z?a-= _x?=S S 90 DAYS F--Cti h a?PROv1 y)�- D7 SOT �I:L .� %•RAS_ I?fJ:G:E f£Rr]-7�Pf 1�SD'+. <br /> P:P'-ZCtErAIR <br /> ?A SIT- 3 ?RO-Ecr 7.0 <br /> COKI : I.I <br /> i I .£?S�Ct c t <br /> t 209 461 -6337 <br /> �. � /• PHONE ! _ )� / C_.11./�� "' <br /> { �DRESi O J C.Jr <br /> 1 ax0$$ sE� <br /> I PHON" i <br /> � ' � �a� • X7.2 D9�2' <br /> ELITE IV ONTRACTORS, INC. ( ?HON£ s <br /> 209 462-6337 1 <br /> r 1 COxrrRAC7OR - DRESS 2535 WIGWAM DRIVE E U <br /> -,, , 660016 <br /> T ' 1 cLxfs A,C, 10,HAZ i <br /> R 1 Lb[SORFR . <br /> 046-008761 i <br /> C ; OTHER - <br /> T <br /> rirr+..rr ra•�rtr u.r.rr.F rr...r 1 PHCNS 3 <br /> s[[s ututaa•a.a.a♦t:uatuua <br /> iD S I�\= SZZE m'Er.IC1L.> . <br /> J79-- `rORED CUX3tEKILT/PQE�ZOUSLZ DAIS tTS:STL'�1 ALLED <br /> i <br /> __j <br /> 1zf1'3fI1IIfI� ?Iflifllliillllllf3llll[[IIIIiI/IiIfI[Iitlit[Iii(11IIfIiIJIfIIiIllI22IFII'IIiIIITiIIitIfilWilltlllll11111I111 <br /> t _APPROV-.n V APPROVED wIT7t(OSI"—ON(S _ DISAP�RWFD Ii <br /> v I ?I.A.Y R111/�%rE.�L1 VArsE`✓�A��J�C:J � .- _ D)R'£ `\ ,�� �` T <br /> �IilIII31IIIIi[IIIIiIII[fIIIIIIIIIEIII,fiIIlllliflIil I it Illtlitllill(ililil IIIIi Ifiil[[IitIIIIIiI31 �" <br /> :e7?LICANY HV 2-RFORn ALL vORX _H A�CRDA_vLT �T'�g t-T i! _ ATE LAvS_a12D 2i7LzS ,.XD 2EGpCA1ZOIZS Oc t <br /> -. v JOAQUYN C-X)*' ?""LIC tIFa <br /> . -X L� SZRV'1�S_- G:.1 OR LIC.F1•SED AGDI-$ SIG i ...-.- <br /> ..i�i'�fORJ'llet - Ot- TYE aORSC ZSSUfb_ IF ZF_S ZkIE FO'_�OrrING� 'Z C3I':FY MAX ix <br /> i <br /> iO? 17[7CIi TICIS 2�SZ2 IS I S.S. NCI- zmmoI"ANY 4-R:,OK ZY St.CS A <br /> S.11.'FCT PO s:_a ._ _ COrrP"�Mu%;�LO} ZAuS OF !al..:`^.„NI,A_' C 'tAss+7F37.AS TO iif':[Tlf 1 <br /> OK-RACTOR's RI�lG OR SUBCUKi4 Acrxw-SIGv>-ZAZE CE[IIFIF.S Tn. ivL1L>•[pn7;:1 <br /> O-F =II£ arG FOR "'CH TH'S PnMI IS IS>:/ID L SfDu:L trJP ) <br /> .PSI'M.N.-.",a . -. .n G,. .•N _ - _ L 7 P'-aLOKS SUi.IECT.J '�O^.r�3Z'S [ <br /> _ <br /> _:er_cAa`rs <br /> n 3ica.te pile respc;usilT�e party to be billed s"or additional PHS-I HD staff time xpeudeci <br /> coverage per tauk-- If the party <1Asignaced below is diiferert than the pe-.*tit <br /> pr:,perty owner, t_�e party mIISt ackaowled e this <br /> g r,sponsibor t <br /> ility fox, bi'_linu <br /> ivaara:<- --lild date below. _ <br /> addr s / _ haae number,w <br /> _S t �/� <br /> CC�►J�\� S O"F <br /> r='.$ 23-0038 �A`iT{adJ� �1 �� CjCG�j.J�+C� �iP> Ac ��f� '� �C9 (iC7�3Tc\f�1►�1 '�t <br /> OR <br /> :� . �t�i '�'C��'R•1�C�\C;� i�.�Ya>� � G��i� �1.�.C7R-."� �.� Q�s"�, . <br />