Okaloosa County BOCC — October 18, 2016 — FY16 FWB Museum final payment

 ,- RULE 14-43.001, F.A.G. STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 575-070-18 RIGHT OF WAY- 08/08 APPLICATION TO PLACE BANNERS ON NON LIMITED ACCESS Page 1of2 RIGHT OF WAY /...----- { ( APPLICANT INFORMATION 1)r -i-~ .}a o..rK ~ lh.1-\fal Ce~"~ Telephone#: (b5DJ 1 '?3.,t] '595 Fax#: lRSD) =&}~.,q£,'7SE-Mail: ~:+1-!-.l...!:&=·+::~~~e=--....L..Y.=-=:..:__.:._i__---l Contact person (This pe~son ~ill serve as th1, cpntact person fo.r all questioni ,ron rning the banner application and placement): (0cu I Le, f\11"\ IVlv..ie.r (\.-\ \,l~W f\i\o,.V\U. eL Address (if different from above): 'SCl.Wle Telephone#: /. --'F=a-x_#_:-"--r-------E--M-a_i_I:-/--,------~---------l Date of Request: LOCATION AND DISPLAY PERIOD This is a request to place 0 pole banners [Z] street banners 0 on the right of way of: Highway name & number: Hw 98, SR 30 Miracle Strip Parkway SE- Big City Location 11.65 From (south or west limits): Florida Place SE To (north or east limits): Per Ave SE Highway name & number: From (south or west limits): ~~~~~~~~~~- To (north or east limits): ~~~~~~~~~~~ Highway name & number: ( r From (south or west limits): To (north or east limits): Highway name & number: From (south or west limits): To (north or east limits): Projected installation date : _............................. .... t)'" L l <........L~-'--'=-~~-+-~--'>J-'"-"'->-f--_._-;-.;;;;.__,.~~~~~~~~~~~~~~~ ~ Banners will be removed on or before (if applicable): ;), Signature of Applica t ii'-"<-""' -< ~f)U,,t, tA) ). or Contact Person: Date: LOCAL GOVERNMENTAL ENTITY APPROVAL Name of Local Governmental Entity: