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HomeMy WebLinkAbout0527 ` 19g:30 ^ i . ~ .'~F G.=i-.. ci ~rput~.ew1 ~ Ile.:~n ~o~ f~~:..i.~:.u~..t Jrrvi:n QTAt[ FIIS NO. ~ P~O::DA TY7E. Oi •i~NT IN REGtiTNAR•f RIO. ?::L::.hiHT ~NK L1fCEw3i0-N~E ~ou ~ a.~ .•u . Si~ ~DwiE W OEwiM ~ •o.~., nu ~ xc .:..::a.t ~i~^~ ~ ~TA.ti~~$ S ~ :VIS ~Iale JulY 17, 1970 60~'1 awCf v..~~. •.wa..r~KU. u.w..,u ' wGi-i.s< ~ O~Ti Of WTN ~~o~n.. iCOVnTt Oi Gfwiw ~K. v~( an.~.~ ~ru~a. r~s 1 J.•s +Jw~s •.«w , ~i:~. . White 'M 70 'S, : ~ nri2 21,189~. St. Lucie 3 RY. iOwrr. Oi ?OCwiWn Of OfwTn ~~.~o. c.~ e.JSn:~; Ga OinFa r.SiJUiqh-nNwf !O~ M ~~b1~. GA1 {fqft 4M MM~Nt ~ .•r... o• w i i Ft. Piezce l.~s r;., Pierce Memorial Hosnital , SrwiE O? ~.ttee er .or ~?•.+.u ~GiKEn G ww~: CO.w.;:r ,...;:.:J. n:via wwa.fJ, j1WV~vr+G frOU3E ~r .w, ow~ w+u~ wr ~ 1 cw+nn~ w F~ ..~~,RC:4~wc~n~ f ~ „~,,.,.,~.a,.,~. ~ VOrth Carol~na!~ :1Ssy ;y~•.,:~iyQG Florence B@I1~JOW `i++t~f N[~~Ns ~~a r e~~u. SOCtM SECu4i11 MW~[~ uSUwr OCCWw:.v~ ~..o u.G~~ ao+~ aw.«o .~oN w RM47 Of WSWESS Ol INONSTIY OCC~~4O r ~OYrQ ~.~r t.~~a ~ „ 481-30-1587 ;:y r^a;-:~:er Agricult~tre 4+C~ Y7M s.w~.. usatNcE-srwrt ,COUkf i G7?, iJrw, aa iOC~I.On i~~.•« c,...~..~ st~~ '~~BOX 167 ~ ~~~:lOi1C3d !tw •S~..I.L'C1@ p ~'v~ca..uaro~, : ierce \o . . Mic~~,rav Road IwTM(~-I.~HI .~M ..1a~ ...r IM~SNti-hM.Jfnl1AME rrM r~M~ uY - ~ LSr.obt. ~t Unob t . ^ I~+Ww~ht-HwiwE wvay ti~ wJ.::F1S ~~+.e~. u~.~ wo.. eor w ww, a~•~. ~r~ n ( j ^ i n~ 11~_ .s ~ _ i ~ }N'~-i ~l~i.~C 3 `F ~ G • 1wRT 'OfwTw W~S CwU1fD • ~an":t J~.r G~E U~Si ~E~ ~.t.~F EOi i~w AL wr.D Wi ~w~.u. o.sn ...a oa.r. i " r~lw4 C~rM + ~ ~ / / + ~ . - : ~ _ - ~~/.^.L ; c.~ ~Mi~.i _ w~ ~O. W ~ (Owi~w~...~ J. i " =o..o~~.O~f. •r •rr . c~.~ ~.s~a0 I :~i 1 ~ ~r~1 y~~~;w~ yt+ ~ . ~ M ~O. p ~f ~ GOwaJ.n+aa G ; . " MI G ~ • C~~M ~~~t ~ i . `~.ii+, (t) t ~ t+~~r a Olnit Sd1wI{.wi COi'~IIO~+i cwa•,a.+> .o..•...~r.w w..-:. ..o~ u..na ro urw c..~« .w ~wiWSr YES ..~s~..o~ ca. . ~ ~ • . ` ~~p , o. ~ ~ - n _ ~ - . ; : . : . ; l,... o. r ~~01ef1 ~w qp~~.ww0 4rY ~ ; ~ r :Y ~ .>..«a.. ?CGDiht 5+~~~.: E O~ ;DAZE a .AKi1~-~w~~. Yr, , ~..~~.i nOM ~nhl~Y OCCYlREO ~ ~wa~ .raw W .~w~r .w ru~ . w rur h, p. ~ h~r~C~DE. O~ W7~I~~r.r.tD +.oM ' ~ . ]t' :w :i IhWft A? hQiS 'I~CL O~ W..ri1.+.ar...o. s~r~:.... . aJ:wL~.v ,snu~ W~~• w0., GA W q~r. ~r~w . ~ ~~lUI'I nf M ~O~ ~On~[~ MIO.~K ~fhCr~ ~ r.. .rr CtO~JKA~:~l~~ rO~M M~ •~V ww.w p~• •l.~ ~ -~f' M~ ~.~'M~ ~..r1 Ow C-0/J~O w01 ~y' p~ATN aC1IUlO M Ml~. O+'wf IN~3K:~M~. SG ~~.Y~'~ 4~ ~~Y i~01~ ~~r~~ p~M i~O~r~~ 0~~~. ~~0. ~O w~ ~f~ .n~.ou r+~ ~ ~ 1 % ; ~ ' v • ~ / . 1 ~ J i o... ...o..~z~. a.~ o~:..,.~ J„ / . . _ ; •3~~ I ~ r.. r.,~. ~1 M .o .r, CUi~~GAiepea-M(p.Cj~~ Erwr+.ES Oa WiG~Fo o.. • • e••r.. e. a. w IN NCtJ1«~ ~U ~~O~~OYK~t NV ~..~w~t.a. W M q0~ .w: - • M rM w~~f~l.~•tiw. ~.~..J.. rO+M N~ rt~~ ~ t ~'~'s G~~fw OCCV~~fO O^~ W~~h ~~O NR W~~f C~uf! f• 1r~*~D . ~ _ _ _ - „ • n. .1 ~sL:' _ i 7 _ _ 1 YT~: _ l CI . « CkiiJ~E~ ,~wAMi ~np q r~..r. =i S.G~~:..ii. / ^ w441 ~v u: ~ ~0~5~ +0~+•w. wr,•w~ _ C-.-':?_LJ / ~.J < _ ~ - ~ ~a~ 21 7~7~; O wu~in.G ~aJ'vif51-:(fJt{~ ~ .•'a - '---'-c.-n`a +o~.. ~ ~r.n ~ ) w ? • ~ f ~ - r 1 Y ~ . , , - • i~ ~ ~ l t H _ ~ ; wa~~~. CtcawT~Or+. ~[rOvw~ .C4.¦:c.r O~:u w:J.~-n.+M: .OCwT~ON on O~ w~w s~.+a ~ r.c... 7., 3urial :i~; ~e Cizv :,a-a ~erv c t. Pierce ~ Floriaa ~ JAlE ~Or~~. M~. , iJhiwti n~.Mt-~.AV: ..\.j ~,:;iitSa . t'~~~' O~ ~0., C~T O~ p~ 11~f~. L~ ~ ,_r~2Y Z9.i97~ ;;,.3ai~-c =u^`_a:. : o:~e,901 ti. 7th 3t.,Ft.Pierce,:la.33s5~ Y. S. ~O i2 /+Mya. J.7f T^ IJi / ~"u_ , ~ '~i-Lw~.~"..~ ~ OAtI vl!O ~1 ~04~ /EG~S~W i~v. iYi"v ' lI/'i:-'~~ G.i~--/ f. _ ~JI ~iM~ •~lVI?C1~~~J7V e i ~ horoby cerrify thls ro bs • true ~r~d ao~-~.;cr capY cf tf~ Loc~~ . Registrrrs rxord or~ fiJe in the St. l~ci~ Counry Hrahfi 0.~ri~ ~ ment at Fon P;erce, Florida. (YVarninp: Not va{id unleu rais=d soel of tha St. Luc:o ~ F~~~ ~d REe~ r' Ca+ntY Fiea~th Dep~rtment is afrixc~.) ST. L.UCtE C011NTY, : j~ ; R ~ORO VEr~lF! M~:-:,~~fs; ~ w•~ , N. D. MIIIER, M D. ~O - ~ County Health Officor ~ Lou) istru ~rQ s~P =Z j~~~~ t,a~? . 1 f~~ r . ~ a=~S - . ~ ~ ~ ~ - -i .~f~ _ , a • ~G ' +'•~t~~'~ } ~ • ' ~ Wf^'y ~ISitd/ ROG~ rV~ r ~J~~~~~i • ~j ~ t CLERK CIRCUIT , ~ ` • . ~4~~~e ~ 5 .,,7: EooK 187 ~A~E z? ~ - _ ~ _ r..~.r x -