HomeMy WebLinkAboutATC FL_Midway Rd_5100 _Security Bond_form.doc
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: 4700 Exchange Ct. Boca Raton, FL 32667
Phone Number: 404-618-4501 Fax Number: _______________
3. Location of Tower (Address): 5690 Environment Drive Fort Pierce, FL 34981
4. Parcel Identification Number: 3406-501-0040-000-5
5. Lease Holders Name & Address: Verizon Wireless 4700 Exchange Ct. Boca Raton, FL 32667
Phone Number: 404-618-4501 Fax Number: ______________
6. ID Number of Bond, Irrevocable Letter of Credit or Check:
7. Permit Number of Tower, Antenna or Antenna Array: : 2110-0725
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