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Permit 220 12th Streetr/ ~.. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number 10-00000582 Date 6/21/10 Property Address 220 12TH ST Application type description RIGHT-OF-WAY PERMIT Property Zoning TO BE UPDATED Application valuation 0 ---------------------------------------------------------------------------- Application desc concrete to pavers ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HAWKINS, ROBERT OWNER 220 12TH STREET ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit DRIVEWAY PERMIT Additional desc . Permit Fee 35.00 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 12/18/10 ---------------------------------------------------------------------------- Special Notes and Comments Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A sewer cleanout must be installed at the property line. cleanout must be covered with an RT1 concrete box with metal lid. cleanout to be set to grade and visible. Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Pavers in right-of-way to be installed over gravel base. Use of limerock is not permitted. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35.00 35.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 35.00 35.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. May 0610 09:19a Linda Walker 9042120564 p.1 ~ , ~~z l ~,~,~;• • CITY QF ATLANTIC BEACH ^1 CONSTRUCTION PERMt-f WITHIN CITY RIGHT'S OF WAY AND F.ASElv1ENTS t~ . , r,,,.:..:r ' +~ t3d0 Saminale Road 804-247-5800 Atlantic t3gach, Florida 32233-5n~45 Fax 904247-5845 Date :~' ~'- / 0 PERlvti7 # ~~~ ~~~ ~ r_ ~~ lssuea e~ rHt_ etTY Job Address I~ .1 c Permitee: ~d'/"~~`-f~ N Q(1~ ~(/7.~ Telephone# ~~- lyD~~ Permittee Address: ~ ~`~ ~~~ ~1~~T Requesting Permission to Construct r) v~ ~- Location: {Reference to Cross-Street} ~1~~~ ~~~~- - 1. Applicant declares that prior to filing this application he has ascertained the location of ail existing utilities, bath aenia! and underground and the accurate locations are shown an the sketches. A Letter of Notification was mailed to the following UtilitieslMunicipalities: ~ ~E. ~YVG Jacksonville Electric Authority Yes ( ) No ( } Date: P~ G 'r0 Bell South Telephone Company Yes ( ) No { } Date: G(1~ Ferrell Gas Yes ( ) No ( } Date: Camcast Yes ( ) No { } Date: 2. Whenever necessary for tine construction, repair, improv®ment, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said s#reet or easement as determined by the ©irector of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall b® immediately removed from said street or easement or reset ar relocated hereon as required by the Director of Public Works, and at the expense of the Perrmttee unless reimbursement is authorized. 3. All work shall meet City of Atlantic t3each ar Florida Department of Transportation Standards and be performed under the supervision of (~.~~.~''1S ~~©'~'~ (Goniractar's Project Superinbendentj located at 3l5 {~"` r°EU`rr rt1 as~?~ ~ GF7 ~ Telephone #: ~~3! ~ taSF/! 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. Ail city property shall be restored to its angina( condition as far as practical, in keeping with city speafications and the manner satisfactory to the city. 6. A sketch of plans covering details of this installation, as well as, a copy of a recent sure®y shall be made a part of this permit. Calculations showing any increase in impervious area on owner's !ot or in the city 7. This perrnittee shall commence actual construction in good faith with days. If the beginning date is more than BO days from date of permit approval, than permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, Title and interest in the land to be entered upon and used by the holder, and the Holder will, at ail times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and a!I loss, damage, and cost of expenses arising in any manner of the exercise or attempted exerdses by the holder of the aforesaid rights and privileges. 9. The Director of Fublic Works shaft be notified twenty-four {24) hours prior to starting work and again immediately upon completion. ~'`~ OWNLR Signed: '/~ Dater (7 ~~ ~fp~~-y ~~ Before me lhic ~,v7 day of the County of Duval, ~~~ ~ ~® State Of Florida, has personally appeared ,~ OeJ ' s +,tt~ NOfB RAIt~iE MfilDE Notary Public al Large, State pf Florid C nay of Duval. ry PUbllc, ~~ Of Florida My commission expires• ~ ~~ 1 D ~m~~DD822137 nown; 3"r- 4 ,_ or ~t'r~mm: expbes Sept 1 f, Zl)i2 nfifrcatian: ..rctnrL ls~~" ~cf'N~I ~ ~`T7` May 0610 09:19a Linda Walker 9042120564 p.2 ,/~' CITY OP ATLANTIC BEACH O8- ~~ ~J00 SEMiNOLE ROAp, ATLANTIC BEAQi, F7, 32233 ,•"~ ~ ~ DFFlGE: 961)247-5826 ~ fAX NO X904)247-St34S BUIL0ING-0EPTQCOAB.US `' ~i SUfLDING PERMIIT APPLICATION DtJVAL CQUMTY 1. JQ9 A D RE SS: D F WORK: 2. VALUATIt]n10O 3. S4. Fr, t.MIOER ROOF rr ~ j~ f ~ r 4. LEGAL GESCRIPTIDN: S. CU48S OF WORK: 6. USE Or STRUCTURE: G NEW ButL08Vr' ^ DEA:QUTION S10ENTIAL LOT.__._ BLOGK ~ SJB DIYI810N ^ ADDITION ^ CONVERTING USE ^ COMMERCIAL 7. g E5CRIPTIO R K : N OF W O ALTERP.TKMI ~ ACCESSORY BLDG. 8, FfRE SPRIhBCL.t~t J y ( ' ,~~J~Q' ~ /~~J `, p ~/~y / ~/ ~ / y ~'~ ~ 1 ` ^ REPAIR CI POD! l SPA ^ YES „L~lYA 1 . I Gy r rl/T f/f ti/ /'r ` v J t,~ ^ MOVE ©OTNER ^ NO P1'tOPERTY OWNER CONTRACTOR: ARC[iTSGT 1 ENCiWEtc.R: 9. N AM E 15. COYAPA N/A~ME/_~p ~~~7 r !~y _ ~~ ~ ' YS. COMPANY NAM°_~. 4 i V(1Zr~ ! /Vl. P J~. J} ( ~ ~ M1V ~t..'1 ', ~i~+i, ~/t Y1 Y"Y N~- I i r 5 16. NAME: ~ ~ 24. LICENSEE NAME: ~ ~ ~ 10. ADDRESS; 17. STATE OF FLORIDA iJCENSE NO.; 26. STATE OF FLOR)OA LICENSE MOB 18 Al)GRESS 'Yd7 9 ADDRESS: 26 ~7 ~~~~ ~ I~ f ~ . / .Y ~ ~ J . .t-YYt` 1 { r` ~ 1 J t G liC-' ~+ ~ . f 11.OFFICE PHONE '12. FAX NO: 18.0E ICE PHONE: r ~ f 20. FAX NO.: 27. OFFICE HON E: 213. FAx NO.: r 3~-o l 3 ~~ a -os~~ 13. CELL PHONE: E[~ /_ ~yD r 21. CELL PHONE: r 29t. CELL PHONE: fa E31AIL 4DDRESS: ~ r v k: i ~q 75 tab ~ l ~ Y 22. EM DO ESS: n~'0v ~'~ ' f ' 30. EMAIL ADDRESS: 1 ,~ : >iCt s v1 . ,~oG r ~nn~- ~ ~~s ~ FEE SIMP ti0 t~ osfleR rwwgwf~q t30NDINt`s COMPANY: 1NORTG,0.6E LENDER: 31. NAME; 33. NAME: 35. NAME: 32. ADDRESS; 34. ADDRESS: 36. ADDRESS: Application is hereby marYe to obtain a permit to do the work and instaNations as indicated. i Certify that no work or installation has commenced prior f4 the issuance of a permit and ttlat alE w4rlf wiN be performed to meat the 5tarldards of aN Jaws regulating COnstrudion in this jurisdiction. This penNl becomes nuM and void if work is not commenced within six (fi} rnonlhs, ar if construction a work is suspended or abentfortlad for a period of six {6} months at any time after work is comtrlertced. I understand that separaLa parmJts must be secured for felactrlcaf Work, Plutntsin , Si rls, tNetls, Pools, Furnaces, Boiltars. Heaters, Tanitls, Air CondRioners, etbc. iDWNtcR'S AFFlDAYIT- I certify that ail the foregoing lrifonnation is accura6B and that aJi work wilt be done in eompliance with Bit applicable laws regulating oonshucticn and zoning. t will not occtg3y or use the referenced building or any part threrof, unts all inspections ere finaled and prior to obtaining a certificate df octxrpancy tx completion issued by the twildlnD official, as required by law. *** IMARNING TO OWNER: *** YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION, iF YOU INTEND TO OBTAIN FINANCING, CON5ULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Ot1VNER or AGENT CONTRACTOR pi AgonL Power of AGcmrry or Agency Caller RCyLired) (QuarlBar Only) Signed: ~~ ~ Date: J'/~d/l/o Signed: Data: Before n1a this day ai, , 2607 En the county cif Before me :his day of _ _ ., 20071n the county of at, State of Fbridfar, has raersonauy appeared Ouv~ quval, State of FlarECa, has personally appeared j i~C) t7li Q.l herin by himse'#! herself and affirms that sit statements and declarations are herin by hlmseli! herself and affirms tJ1at aii statements and declarations are true end accurete. true antl acet:rate. No~ry Publte at Large, State of ~, County ar tPCr I Notary Put:llc at large, Slane of __, . _ ___, County of _ _ _ ~_i P rson,dly Known .I I 3 ' ~° Q Penonafy Known Prxf~cec tdarufirauon - FJ 07 41 , ^ Produced ldentlfcatian - Notary SignaturB: _ O'/Q!,rW~~ _ A)otary Signature: ., _~ __ COA3 FORM BLDG6f: REVlSm: 1110/2068 IAFIAINE WRDE Notary PubliO, State of Florida t:ornmksionff DD822137 nay immm. expires Sept t 1, 2012 May 06 10 09:20a Linda Walker 9042120564 p.3 NUTIGE £?F CUMMENCEII~EN'F State of I" '~' V~ C~~• - _ _ - - _ - - Tax Folio \o. County of_ ~~~ ~~''+ To Vvhom It lt4ay Concern: The undersigned hereby informs you that improvements ti•iil be made to certain real property, and in accordance ~~~ith Section 713 of the Florida Statutes, the following information is stated ipp this 1~iU 1'ICE OF COl~llvt _CE(41FYT. Legal Description of property being improved: Cp- / I too '~S- ~ ~ Address ofproperty being improved: r~~Q ~ j~¢!tz/l f't'G t~GZ t!('? 3~~3 ~ General description of improvements: ~~Gr ~'..~-~. ~ °' ~G,,.~gr-5 pY) C_~h ~`~. ~-- ~e~~. Owner ~ f,~t-{'~• ~.} Li.ti'~`~.1(j ~, Address: tSQ.J'J') ~ Owner's interest in sire of the improvement: ~ w ~~ Fee Simple Titleholder (if other than owner): Name: Contractor. j~[~~Z.°~"/")!h. ~iil (l~ f'" s Address: ~ ~ a~1 ~ a ~~~r ~~ ~~ ~ Telephone No.: ,~ .3''7r~ `~~~ Surety i;if any) Address: Telephone No: Fax Nn: Amount of Bond $ Name and address of any person making a loan for the construction of the improvements dame: Address: Phone Tie: Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other docurnen#s may be served: Name: Address: Tclephane No: Fax Ito: In addiCion to himself, owner designates the following person to receive a copy of the Lienor's 'Notice us provided in Section 713.06(?)tb), Florida Statues. {Fill in at Owner's nption} Name: Address: Telephone Na: Fax Ka: Expiration date oFNotice of Commencement (the e xpiration date is one (I j year from the date of recording unless a different date is specified): THiS SPACE FOR RECORDER'S L'SE O]tiLY UW'r1ER / ~ ~' ~ Si~tted: u` _~1.~° ~ Date: ~ rd's • WgAlN~lIVAD~ Note P ~~ ry uWlo, Sfete of Florlde i3etbre me this tby etay at olo _r~ OI'Flvrida,ha~pcrxm~llyaptnarccl d ~' F vot:u~y Pubtf~ at { ~irgc Statc nr Plrst•ida C'huna oCi~uval in the County oCDuval, 5[ate 1nJ' CommlBSiotl~DD822137 , , y b0 i n n i i d` ~~ ~()/2 ~ _ ~Y l~ttdfit~ expUa6 Sept 1 i 20#~ ycua m ss exp r~: c> Q Personally Krurwn: nr , ® _._ (~no-dazrcd(dentificativn: ~ ~ilRi~ La' __ LMtG ~ ~ Ql_-L /'7SOZasv ~ GJ~' Faxl\o:~ ~1~- DSd%i~ May 0610 09:20a Linda Walker 9042120564 p.4 R.Q.W. Permit Attachment R.d. W. Permit # issued of 20{}5 Owner's Name: Property Address for Atlantic Beach, FL 32233 ~.ah~`~ ~(,~Lt1~:in,5 Subdivision: Lot # 1 Block #: ~'~ ~~' `~S "~~ R.E. #: I `~ b~2g' ~- QQ D C~ REVOCABLE ENCROAC[iM>Er~tT' PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this ~~ day of ~..G~L , 20~'? by Atlantic Seach, filorida, a municipal corporation organized and existing under the la~4s of the State of Florida, hereinafter referred to as "CITY" and 1~~~-~ ~l~u.v_~:rnS of Atlantic Beach, Florida, hereinafter referred to as "USER'. V4'ITNESSETN: That the CITY does hereby grant the USER pernussion on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Seach Right-of-~'aylEasernent permit numbers noted above (copies attached). This tivork is generally described as: ~~~'3~Q-CG ~{'Li.Y~ ,~rD G~ ~iS~ f,G}F'~Gf'P~{~, ~h~~„ .nr~+~tl~'~ Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty {30) days notice by CITY to the USER, said notice to USER shall be given by certified mail, return receipt requested, to the following address: The depositing of said notice of cancellation in the United States mail shall constitute the notice of cancellation and the bwden is upon USER to keep the CITY informed of USER's proper address. The USER shall promptly make any and al] necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at elf times maintain said facility in good and safe condition. In the event it is necessary Far the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code, and all other land use and code requirements of the C1TY. The USER, prior to making any changes frarn the approved plans and/or method, must obtain written approval from the City of Atlantic Beach, Public tiVorks Department, for said change. The Page I of May 0610 09:20a Linda Walker 9042120564 p.5 USER shall, at the discretion of the CITY, be requested to submit as-built drawings showing the change within thirty (3tJ} days after the day of completion. This permit s12ail inure to the benefit of, and be binding upon, the USER and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY caws andlor specifications, to include utilities locate requirements and use limitationslrequirements of public rights--of-way and other public land. USER further agrees that the CITY and its a~cers and employees shall be saved harmless by the USER from any of the work Herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER. DATED and SIGNED this ~ day of ~.<~~ , 20. CITY OF ATLA;'VTIG BEACH, FLDRiDA, ~By: ~~~!Q. /~~t a municipal corporation; Property Owner By: Attest: Tim Hanson, City Manager Ride Carper, Public Works Director STATE OF FLORIDA C(}Ulr1TY OF DUVAL On this /~ day of ~q , 2U(~", personally appeared before me, a l~vtary Public in and for said Coun and State, ~abrr'f' ~ ~1A~kj,,.s ,the property owner of ~Z~r ~ t,~( f~ ,Atlantic $each, Florida, known to me to be the person(s) described in and who executed the foregoing instrument; who aclarowledged to me that he or. she executed the same freely and voluntarily and for the uses and purposes therein mentioned. otary Public in for said County and State Property Owner (ta be signed in presence of the Notary) ~~+ ~ LORAINE WADE Noffiry Public, State of Florida Commission~ DD822137 MY comm. expires Sept 11, 2012 .:yy4l Y' Page 2 of 2 R ~ . EJ~'. ~1~Pdj ~.~~ _ 1 . i ..... #?• ~ D , ,. ,~ I , i ~ ~ ~ y , t -~.. ` ~ . _~ ~ s ... ....~ 4 l < . u ~+K ... .._._....._.. _.._ • r-r.. .-wc .~az+a+ - r. o sw "V L O ~ __._ ,_ .~ * A E,i' .4' wr }w Yr ~ ^ R'7Y V •l( ~t 'YYY!IK ~•~ :. Y'Lq blr 'Y'~illY~~ Y~ ~M..u.9~6 ~+Jiwwu a iMr rs:.~^' rs'. .. r. w. y ~_ ~~~~ ., ~~ d I i r d.'..:1: •w. ~ ~~~~~~~~~~, ` .r ' -'~ ~ ^'--- 43rro F54' ~' :.~ 7 _ . « ~ Ia~e.Aa t'Y6: •z:~ N^~I;a* ? rAr':A<rs' . . ry.. ~ ~ V ~ • ~ ~ ', ~ Q '":9 ` I ~ ` ~ °° ~ ,• s u.9b FuE` , ~ ., ' %~ PFF' . V _...? '~e^r; ' .".9.r.: Y'5l<,' ' ~A'JE?~i • FF''~ AF7: yl4.«'.'19Fi ~ ..9,6 ~#; +F' TA _ _ . lk SNi ` Jr ~~ »~. ._... ~. ~ +~ <r 4 . W? ,_R, ..~ ~. _ ~. ~ ~ E.isr~ ~J~~ rF W z W ~_ Cn W {.~.. z a° ° a° o\° o~O~ °~ ~ 0 O O o M M M I`~ M ~ N O M N1 tO M N M d' a H ~ ~ O a d O G u1 . O ~ a ,n ut l0 ~. ~ N te e-i 00 v- et M ~ a -! N N QMi N N M cT° a° ~° ' off' °~ ~ N M d tD tt d ~ M ~ N ~ ~ N ~ ~"~ N N ~ R W M lD Q1 t!1 t D r+ M u~ ~c o ~, ~. n. a a +.. ~ ~ Y ` v ~ - o .~ m x -~ ~ m o ~ Y ~ 3 O ro u 3 v v u ~ ra m m p a n n t~ L L L W ~ o N ~ ~ ~ J a . ~ a ~ --~ ~ ~ ~ o `~° u ~` ~ `'° 3 ~ ~ ^ O > > > a' a C w ,v'~+ 7 a' i a ~ ~ .X o rs ro ro ~ O ~ ~ u o c~ ~ a w oc n. a s a u Z ~ W u oc :~ °.~~i~~~.~,_ City ®f Atlantic Beach ~~1' ~ fir, Building Department 800 Seminole Road '~°` r" Atlantic Beach, Florida 32233-5445 ~~_ Phone (904) 247-5826 Fax (904) 247 `'- ~~.~,, ~,~ ' E-mail: building-dept@coab.us City web-site: http:/1www.coab.us ~~+~•~~ APPLICATION NUMBER (fo be assigned by the Building Department.) ~~,~~ Y Y 2~~o r~ ~- Date routed: ~/~ APPLICATION RE~I'IEV~1 AND TRACKING FORM Property Address: ~ Z. d /~ '~ ~7" Applicant: ~~1~J~i~ Project: ~~ ~~ ~r£ -'~ ~i¢ V ~~s s Department review required Yes No Building Planning & Zoning Tree Administrator u rk Public tiliti Public Safety Fire Services Review fee.$ DeptSignature Other Agency Review or Permit Required Review or Receipt of Permit Verified B Date Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: Reviewing Department First Review: (Circle one.} Comments: APPLICATION STATUS Approved. ^Denied. BUILDING r PLANNING & ZONING Reviewed by: (// ~~~ Date: c~~~c~ /~ TREE ADMIN. Second Review: QApproved as revised. ^Denied. PU ORK Comments: ,~ ~2 i~ PURL SA ETY Reviewed by: Date: FIRE SERVICES Tlhird Revuew: ^Approved as revised. ^Denied. Comotivents: Reviewed by: Date: Revised 05!14/09 • ,a;-,~~ City of Atlantic Beach ~" "fit, Building Department FRAY 1 I ZdtO ~, f 800 Seminole Road "'~`""' •r Atlantic Beach, Florida 32233-5445 t -. Phone (904) 247-5826 Fax (904) - '~~,,:aa3 ~~= E-mail: building-dept@coab.us City web-site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) /~ -' ~~' Z Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: Applicant: ~~71~iC~ Project: ~~ ~~~r~ --~ ~A /~,~5~ Department review re uired Yes No Building Planning & Zoning Tree Administrator u ~ rk Public tiliti Public Safety Fire Services Review fee $ Dept Signature..- Other Agency Review or Permit Required Review or Receipt of Permit Verified B Date Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: QApproved. Denied. (Circle one.) Comments: ` s L /~, vt 0 /~ ~~'r'`~ 1~1 ~ BUILDING V~ ~~ ~~ ~'"Tt%71, ~~ ~~ fp /'~~vcfv~ric~v /a2~S~eT. /~ o:z9~ ~' v r w.l' rM 'ti S T !~'/~'vt/ t '~-€ ~ Q t^ - v/~C ~ •V T h U PLANNING & ZONING 2~.?'~.P~ ~ ~ ~~ ~Q ~~~...._.--~~-~~- Sy7~i~ A-f}~,...__G..!`~ __ ~`.'x-~_N Reviewed by: ~-~t ; - ~_ Date: ~ ®~ 1 ~I U TREE ADMIN. r'~ Second Review: A roved as revised. pp ^Denied. PUBLIC WKS C mm ts: ~ c.L ~' ~ ~ / / ~~J~ )J~ ~_ ~U~ PUBLIC U CITIES ~ y Y),~ PUBLIC SAFETY Reviewed by: Date: t~J i FIRE SE~VICES Third Review: [Approved as revised. ^Denied. Comments: Reviewed by: Date: ~>' had/v{ ~ ~~ r~v~/tS, f-i/l r/h~~ ~~,-QHI 4` ~ a~e,r w Revised 05/141 ~: ~ l , G ~T" - r~ ~ -~ ~ t t~'- ~ s `%'~Y~' ~ N e cam'. c -,Li c ~ e ~•c~ ~ ~~' r