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LEC-31 -'C�311 93 :32 PM DI�HIt: 2[+63615474 F• �i1 <br /> I; � � � z—�'3 -3 <br /> :� UTHORIZA I' IUI� <br /> 'I'[IIS IS 1'O AU"1'1IOIt1Zn Tl-1L'• LL':�5��, ARLf�'NC�I'TG <br /> Nr1MMAI�KIIOT, TO USL MY !'ROPLRTY LOCATLD AT <br /> 9215 10��� AVc., S.F.., F..VF.RF,TT, WA. 48208, AS AN ADULT <br /> 1:4M1LY HUME. <br /> Tl-IIS AU"ff fORI7.ATION I9 BEING ISSUED liPON CtE�ULST OF <br /> WAR() HOR TH� ISSUANCL OP C�I2'I'II'ICATE :1ND LICET�'SI?JG <br /> OP DSHS, <br /> ��-�.�.�n�� `r,� I <br /> 3llP.�:�O' L S. �4:1 L��. 'CPl'f DEC'EMBER 3U, 2011 <br /> �r_rsso� <br />