HomeMy WebLinkAboutAUTHORIZATION FORM (1)GROZA BUILDERS, INC.
511 SW Port St. Lucie Blvd.
Port St. Lucie, FL 34953
(772) 336-7653 ph — (772) 336-2272 fax
CGCO23870
Date: 9/8/2020
To Whom It May Concern:
Carlos L wells ]ennifer L wells
I (We) ,hereby authorize Groza Builders,
Inc. to act as my (our) General Contractor/Agent for the Health, Utilities, Planning &
Zoning, Building and any other departments as required to obtain permits for the
construction of a new residential home located at:
Lot: 1 5 Block: Unit: rnchurlen Fwms
Address: 1'60 ?-�- , er Aer ' �--L
Thank You,
—Docuftnedby: I�1 ,l
_ -- 64H9B6F.1F-?60493
Signature
DocuSigned by:
�C s L was
`�-- F 00926D8F9DL4F9
Signature
State of: Fonda County of: ' l*W i er
The foregoing instrument ws acknowledged before me this day of .
20 20 . by �enc� C * Cox-ci% Wtkk S , whom O is personally known to me, or
has produced dlw2l S 1�CaS as identification, and who did not take oath.
Notary Signature:
(Notary Seal)
BRIANNA GRAHAM
�i
`" tv1Y COP�1MlSSION #GG08910
EXPIRES: APR 02, 2021
°'. [Bonded througP,1ststate Insurance