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ASBESTOS NOTICE PERMIT# 2107-0331
Date: ¢ I Planning & I)evelopment Services Building & 2300 Virgin Fort Pierce, 772-462-155 ode Regulation Division aAve FL 34982 Fax 772-462-1578 ASBESTOS NOTICE TO CONTRACTOR PceM'T # a\oi-ot)3l #e/Gr raoT} Contractor Name: 4jtrycpe`€ zf. #/£#€z.€ BusinessName:4f#f/LS3c>c#r€SZ{C,_____..,._ Address: _+a &iocrEneceo Cl,€-© Cfty: Jcj,a/TEA ,..., State:JEL Zip Code:TS*H a Re: JobAddress: a`roq Nco Gee.galeKiiAe, L~ Pv`Lm c.\Tv) FL. 3tlqqo lt is your responsibmty to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. Signature & Date