HomeMy WebLinkAboutBond Service Provider InformationBuilding and Code Regulations Division
Permitting and Zoning
2300 Virginia Ave
Ft. Pierce, F134982
772-462-1553
Cash Security Fund, Irrevocable Letter of Credit or Bond to Secure Cost of
Removing an Antenna, Antenna Array or Tower
Service Provider Information
1.Name:
2. Address
Phone Number: S6/-ySl-7y`l6 Fax Number:
3. Location of Tower (Address): 40,?0 pe7h'5014 Al
4. Parcel Identification Number: 7-3 ! 2 ' 9/ 2 - Do_ °O
Lease Holders Name & Address: 1-/r s
33322
Phone Number: SO-- 41P-7`/p6 Fax Number:
6. ID Number of Bond, Irrevocable Letter of Credit or Check: 09 10 085
7. Permit Number of Tower, Antenna or Antenna Array: Z 007- 0�21
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Cash, Security Fund, Irrevocable Letter of Credit or Bond to Secure Prior
Service Provider Information (If Replacement Bond):
1. Name:
2. Address:
Phone Number:
Fax Number:
3. Location of Tower (Address):
4. Parcel Identification Number:
5. Lease Holders Name & Address:
Phone Number: Fax Number:
6. ID Number of Bond, Irrevocable Letter of Credit or Check:
7. Permit Number of Tower, Antenna or Antenna Array:
1 /12/2009
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