Laserfiche WebLink
SIGNATURES OF APPLICANT <br />PROPERTY OWNER (A PPLI CA NT) ~~~~-COMPA N Y STEVE MYERS h, Q .. ~ _ c-L~ .• v • gbu:s-~ 2V NAME <br />S IGNATURE ~S \J,.. ',v-' 61 6 SIG NATU RE <br />ADDRESS 1201 ODELL ~HOOL RO AD ADDRESS lao~~~. <br />CONCOR~ 28027 Phone No. 704-788-~/fVc.. ~ftJ~7 <br />2841 <br />AUTHORI ZED AGENT W ITNESS <br />COMPA NY KIMLEY-HOf ~ AND ASS0(J TE S NAME KIMLEY-HORN AND ASSOCIATES <br />(TIM ME fPI ',NTP n (C HRIS STRANGo;) ~/ <br />S IG N AWRE ILl,},! S IG NATU RE ~ <br />ADDRESS 11 720 AMBER PARK DRIVE, SUITE 600 ADDRESS:::: 117 20 AMBER PA'RK DRIVE , SU ITE 600 <br />ALPHARETIA , GA Phone No . 770-619-ALPHARETIA , GA 30009 <br />30009 4280 <br />APPROVALS <br />A7/;;;QICT ENG INEER <br />,,--1'-1 -J ~ <br />\ -I I.. or ~NATURE -DATE <br />APP LI CAT ION APPROVED BY LOCAL GOVERNMEN TA L AUTHORITY (when required) <br />SIGNATURE TITLE DATE <br />APPLICA TI ON APPROVED BY Ncl~rp ~ ;Vi c.-.-6 j)IP'~'Ll' ("u/;!eY'--2.-'J -'ZAl [ £( <br />SIGNATURE TITLE DATE <br />INSPECT ION BY NCD OT <br />SIGNATURE TITLE DATE