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F L
O R I D A
Planning & Development Services
Rini Id i ng & Code Rc:gu cation Divisi on
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-1553 Fa i 772-462-1578
Pe 1, /";- � # ;- () 0 7 - 0 '/ //
AS 13 ELMS NOTICE TO CON MAC TOR
Data: f T
ContraName- �� �'� � A
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Business Name, �M'! + yrc. -44
Addr#
City:
Zip Cede:
Re: Job Address, &W 110#1ex, /V
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It is you r responsi b i I ity to oarnpfy with the provisions of Semi on 469. D03, F Iorida 5tat utl�s
a nd to n vti y the Depa rtment of Environmental Protection of any i ntenti on s to remove
asbestos when a ppl Ica h in with state and federal lave.
Si ture & Date