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Z� �n 11350 N Meridian St-
C�.V a+ e I r" G a Carmel. IN 46032
Contact Name. Telephone,. F�nail:
jeff Law
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1, (please print name) lcff Law property owner/representative of 11350 N.
Meridian St.. Carmel- Indianagives STALEY SIGNS, INC. authorization to submit an
ADLS Amendment application for signage at the above -mentioned property.
Date:
Business Owner/Rep (signature):
S" t
PIease complete form and fax or email to Staley Signs, Inc.
317-221-0123 (fax)
dstaleyjr@staleysigns.com