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HomeMy WebLinkAboutAPPROVED, Security Bond Building and Code Regulations Division Permitting and Zoning 2300 Virginia Ave Ft. Pierce, Fl 34982 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: ___Verizon Wireless ________________________________ 2. Address: _7701 Telecom Parkway, Tampa, FL 33627________________ _____________________________________________________ Phone Number: _410-952-3860 Paul Bailey/Agent Fax Number: ________ 3. Location of Tower (Address): 3100 North A1A, Fort Pierce 34949 4. Parcel Identification Number: _1425-606-0083-000-3_Rooftop________ 5. Lease Holders Name & Address: _Verizon Wireless_________________ __7701 Telecom Parkway_____________ __Tampa, FL 33627_________________ Phone Number: _410-952-3860 Paul Bailey/Agent Fax Number: ______ 6. ID Number of Bond, Irrevocable Letter of Credit or Check: _K09342722 7. Permit Number of Tower, Antenna or Antenna Array: 2106-0511 _____ Page 1 of 2 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 Page 2 of 2