HomeMy WebLinkAboutAPPROVED A2P0322M_Security Bond Document
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: ___T-Mobile South LLC__(previously MetroPCS Florida LLC)__
2. Address: _12920 SE 38th St., Bellevue, WA 98006___________
Phone Number: _813-348-2430 Fax Number: _______________
3. Location of Tower (Address):_10410 S. Ocean Dr., Jensen Beach, FL 34957__________________________________
4. Parcel Identification Number: 4511-514-0000-000-9_________________
5. Lease Holders Name & Address: Hutchinson Island Club Condominium Assoc. Inc.
10410 S Ocean Dr.
Jensen Beach, FL 34957
Phone Number: __________________ Fax Number: ______________
6. ID Number of Bond, Irrevocable Letter of Credit or Check: 106070420__
7. Permit Number of Tower, Antenna or Antenna Array: __TBD________
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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
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