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Get Manatee County Agent Authorization Form 2007-2024

57 SIGNATURE AUTHORIZATION Date: This authorization expires according to the following category expiration dates: Plumbers License, Fire Marshal License, Backflow Device Testing and Repair Certification, and the calibration of equipment. I, of (Print Tester s Name) (Print Name of Company) at (Company Address, City, State and Zip having personally appeared and presented identification, do hereby notify the Manatee County Cross Connection Control office that the signature below is my true si.

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