|
, � � „ CIiY OF [VERCTT
<br /> Dalo Received __� 1._`_���'� � � ^
<br /> Ho�' R�<eived ❑Phone Uln Per�o+ LJLe�ler - -",�-� � ._ ----1
<br /> � ' / • � ) . - _°":" -- -,
<br /> �i� _ `. M A� -�
<br /> Name✓�' -�.' � ti��!'S� Prmne .". 5_ �_ _ '_i�_3-�_ ___ '-_'��19-__- �
<br /> AAdre�s ___��--/—�l���(--_----. Grv __— —S�a�e--'--'
<br /> � .. .. _ . UflClill�C \ 1_1•11(�N'_tM1� f"ULLY /.SrrOfSlPll .. . .
<br /> l.v ��r .� Y � I�G��w.t[.e�' �
<br /> � �:/�, ��ze.�,�,.«�' ,��-c�� , /, ' I
<br /> .�ccs.� .C��I.(�>,--� C.!l7c.�.c-t C1-z�-�. ,R-�M/ �f'is �. �-v,L�_ti i
<br /> II _ �co _,cyy�. /(�-- . � ^�a e!e=� _ �� �- J-JYo- . :�/..�_ ,-7u<_.s .
<br /> I ! / /1i /
<br /> i .- lLaQ-� t<�.J✓f-�1'-,:i�-s�- � �
<br /> . �
<br /> �
<br /> �
<br /> I
<br /> . i
<br /> i i
<br /> surv. nv ni�,*. ��c�o �
<br /> ���o-nnr r�rc.� er � �
<br /> •_ _ __ �_— _ _ /
<br /> As��q�edTe__. �-'-' - --- — '.--_
<br /> ♦r�swcn ou[ � /�� --- �
<br /> l��i IOI.LOWI�IG �C110Y 1��1 YEf.11 11YL�l TO ]Ol.\E f��l'_IiOPLE4 �
<br /> n�1r l) � J� C' � �P .
<br /> '� .,� ._ .�..�— ,-�a- -<f� r�,� �•.�t<<.�Z�..•.: �. - �.— �., �
<br /> .�.r�� ..� ,t
<br /> „� . ��— y . �
<br /> // .� .` ;"/'-' ✓-C��Le<. f . T�_ .-t'l�i�--� 2Ce�c_«-r--. ._.�c.�- •r`-y i .J
<br /> /.l /J /' / /] �[ �
<br /> �..�L �i' ..�.< < .! ��C.. i[s...-!._er�LC.�C'/"J� CC a��_.��• ��LA✓7 /C�C1<f�ll-i-�- �
<br /> / p � / �/ o ��e ��
<br /> �/, �- ��a.A.L`�[/O-r.-� �% ���1`��� ��G-'N ;'��-d'� �`' / y�`� �� � �
<br /> .f' ,/ .rt.c<? � �.-
<br /> i. ` �
<br /> . ,% ' �. � �� _ cf��.+� 1a'a� Gi..� :�<- c�lC� t� �J 1 i�c '�- _
<br /> _ � , c <_� _-�r— /
<br /> � i,/����� �� r��„ .G L� l��. �
<br /> ( �t!r,�.f. i��e �,.. _ et ` rr � c , �c, s��
<br /> , _ < ,C� :a,/'l<�-. .
<br /> ,
<br /> , �/ v
<br /> , � ,�eit.. "�ri�[c • �.T� /��-�-'' • /l;l� e�,,.�__ �t.�� �e'ft--e=-�-o� .t�
<br /> / -f' , /�1 � /' � ��
<br /> . G!� �_��`• _ti C �L�CR-�CA� - . '�l,/ �h�Cd✓ �.�- .�c 1�-�- ,-c_ _. �-<..-rt,.s i/� .
<br /> _ ,� [�-Cl.�... ,;t...._�. �f�zc��P%/e"�A-� '�(.�.-Ct ile��-� N ,��l�..- c%CLti/
<br /> � �� _ ,f tcee��-��J
<br /> ,'�eC�� �L,.� �[�t� �_�� � t. :..: r<�- .;_�r�t—
<br /> / �,;�i1 / �Q o- ,��c,c�t7 /� 6�c�,d� �:c��; ct-t..��--� �� _�t_�. C'� �
<br /> � .�,./�_ .1-e�_Ar� ���_D t /� �(�F'.� .`.�_� ;���.. c��w r.`tf ci !�C'zt. �.
<br /> % /l //
<br /> 0 G '
<br /> , Li.��.�'�i .. �C,l"� �edr' A� �. ��-et _ .t . �e'.et.lirv :/`t�-• �4.l��rl�
<br /> ���' �f / ' ( aY2�-LM j7' _ C!� .-e/<.
<br /> ,. (< � R,I- .t� . . �CC�/��l,et �. (� �.C�/ _-c ��`�-.
<br /> ` �C 2l.�ni.�.LL.• .. . _ d_.�'i_ ..� . _-.�_:T � . _._"r___'—____-__ '—'"
<br /> ii�]�•. �� .�ii �ttiqY �ii�nr� ❑ i . iir�i� � LJb, ir�. lrr�0��[ _ . . .
<br /> / ' /
<br /> � � , . r . ❑ � „ ❑ , � . ,, , �.,t � . - _ �„
<br /> ,.. . . _
<br /> r
<br />
|