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<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 Control within the <br />stipulated limits 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 ENVII20N1VIENTAI, NIOSQUITO vlANAGENIENT, INC.: <br />SIGNAT'tJRE: 126i,--- j! ' 'I`ITLE: Control Consultant DATE: //'A' d-) <br />Brian P. Deenihan <br />FOR THE CUY OGA UNTY BOARD OF HEAI,TH: <br />SIGNATIJRE: .?? , _ TITLE: <br />.DATF: J c7 <br />FOR THE CITY OF WESTLAKE: <br />SIGNATURELZ,?-Pl ? TITLE:DATE: <br />FOR THE LORAIN COUNTY HEAI,TH DEPAR'TVIENT: <br />?DATE: 3 J `U7 <br />FOR THE C LAND MET'Rr-ARK SYSmm: <br />SIGNATUR-E'-?c??- TITLE: GI?t -t ?- , 6N JKz5 DATE: 2-Z?i -D7 <br />`? <br />FOR THE CITY OF NORTH OLMSTED: <br />SIGNATURE: _TITLE: DATE: <br />