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• ? ^ f • ??? ???SV? <br />AUTHORIZATION FOR MOSQUITO CONTROL <br />FOR <br />LARVAL AERIAL APPLICATIONS IN BRADLEY WOODS <br />SIGNING AND RETURNING the copy of this authorization form will authorize the <br />Clarke Environmental Mosquito Management, Inc. to perform Larval Contxol within the <br />stipulated li.mits found on this cost estimate unless otherwise stated. <br />CONTACT FOR AUTHORIZATION: <br />NAME: <br />ADDRESS: <br />PHONE: <br />CITY/STATE/ZIl': <br />FOR CLARKE ENVIRONNMNTAL MOSQUITO MANAGEMENT, INC.: <br />SIGNATiJItE: -&"`-fl TITLE: Control Consultant DATE: <br />Brian P. Deenihan <br />FOR THE CUYAHOG OUNTY BOARD OF HEALTH: <br />SIGNATURE: TTTLE: <br />FOR THE CITY OF `VESTLAKE: <br />SIGNATURE: <br />TITLE: <br />FOR THE LORA-LN COUNTY HEALTH DEPARTVIENT: <br />SIGNATURE: <br />TITLE: <br />DATE: <br />DATE: <br />DATE: <br />FOR THE CLEVELAND METRO PARK SYSTEM: <br />SIGNATURE: <br />TITLE: <br />DATE: <br />FOR THE CITY OF NORTA LMSTED: <br />•, <br />SIGNATIJRE. ' TTI'LE: DATE: <br />07 - 41 <br />?:?;, _ ,,, . -«..--1--, _ - -....