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13 <br />!IL , t } I701i1�'It 1. <br />A <br />f kltt` t tn'r�4 <br />�f <br />INDIAN RIVER COUN'T'Y, <br />SOLID WAS'T'E DISPOSAL DISTRICT <br />sTw> i, <br />1640 2501 Sweer, Vero Beach, Florida 32960 <br />;I <br />Telophono: (407) 5878000 <br />Svncom Telophone: 224.1294 <br />0 <br />SPECIAL WASTE PERMIT <br />atj i01 <br />'y r. PLEASE PRINT <br />W k^,, Date: i <br />k SiIdy <br />To the Solid Waste Disposal District of Indian River County, <br />1' Florida: <br />�b,Y4r; Application is hereby made for a Special Waste Permit for the <br />generation, storage, and/or transporting of special wastes, as <br />ljlprovided in Ordinance 57-67 and amended by Resolution, for the <br />';;i<'... period designated. I (we) understand that it is my (our) <br />responsibility to comply with local, State and Federal <br />ordinances, laws and regulations. <br />BUSINESS NAME: 1 <br />OWNER'S NAME: <br />ja f' ' MAILING ADDRESS:kl <br />LOCATION ADDRESS: <br />i NATURE OF BUSINESS: <br />TELEPHONE: BUSINESS: RESIDENCE: <br />STATE LICENSE NUMBER if applicable: <br />I< <br />d ! COUNTY OCCUPATIONAL LICENSE NUMBER: <br />Id <br />I do hereby certify that the above statements are true and <br />correct. - <br />Signature: Title: <br />` I <br />1 FOR SW DD USE ONLY: <br />r z: <br />This Permit is valid for one year and is subject to all <br />r conditions attached hereto and made part hereof. <br />APPROVED BY: Permit Fee: < <br />Permit Date: <br />Permit No.: <br />Ronald R. Brooks, Manager Expiration Date: ? 1 <br />Solid Waste Disposal District <br />I'd <br />{ <br />,; ;+t ;; EXHIBIT D <br />/dc <br />SWPERMIT/S2a <br />{ —19— <br />jz <br />�yS, r1'41f�r: <br />Sd'J%tt +:'4f'0 ' . <br />.16 <br />f '1 <br />61 %i i} 7 <br />:1 <br />Ll r'LL <br />J, ' , <br />c 1 Hi V„ <br />Ltia Si -t7 r r 1 2 ' <br />