Laserfiche WebLink
Signat re— Witness #1 <br />`3UZA \-\ <br />Printed Name — Witness #1 <br />53'7 -V1-rUst,. G,�- <br />Address — Witness #1 <br />/(iG P <br />Sin ture itness 2 <br />TI:X�1 <br />Printed Name — Witness #2 <br />Address — Witness d2 <br />STATE OF FLORIDA <br />COUNTY OF <br />INDIAN RIVER COUNTY, <br />a political subdivisi the State of Florida <br />By: <br />Sean LiAske <br />Director, Delpartm t of Utility Services <br />Date: 1T'LT <br />The foregoing instrument was acknowledged before me, by means of 0 physical <br />presence or ❑ online notarization, this -AZ day of �: ✓e,v fuf'J 2024 by L1 c sEt- <br />, the i)'/',6" '4 ()� f.'f N . u✓,�r� of INDIAN RIVER COUNTY, a political <br />subdivision of the State of Florida, who is 1115ersonally known or ❑ produced identification in the form <br />of <br />SEAL: <br />Approved as to form and <br />legal suffi 'ency: <br />By: <br />' i.a�w-IG:-BeLxaal <br />t—/County Attorney <br />Initials 6Ir <br />NOTARY PUBLIC: <br />Sign: "L4 Zccct- <br />Printed Name: fes- L., At,', e <br />Commission No.: <br />Commission Expiration: <br />HEATHER L. ALEXAND R <br />Notary Public • State of F oriea <br />Commission N HH 44: X97 <br />My Comm. Expires Mar 7. 2C24 ' <br />Bonded through Nationa; Notary Asir. <br />License Agreement <br />8350 58TH AVE <br />Page 6 of 6 <br />