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HomeMy WebLinkAboutA2P0038B - Security Bond Document.doc 2109-0134 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: ___SBA Communications_________________________________ 2. Address: 8051 Congress Avenue Delary Beach, FL 33487____________ _____________________________________________________ Phone Number: _561 226-9287____ Fax Number: ___N/A________ 3. Location of Tower (Address):_____375 E Midway Road______________ 4. Parcel Identification Number: __3403-502-0055-020-3_______________ 5. Lease Holders Name & Address: ___SBA Towers II LLC___________ _____8051 Congress Avenue ________ _____Boca Raton, FL 33487_________ Phone Number: _561-226-9287_____ Fax Number: ______________ 6. ID Number of Bond, Irrevocable Letter of Credit or Check: _070008906_ 7. Permit Number of Tower, Antenna or Antenna Array: _2107-0702_____ 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