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NOTARY FOR STRUCTURE OWNER <br /> ACKNOWLEGED BY: <br /> Structure Owner( w� L�.� Lr .a Name <br /> Date_),//a Title <br /> STATE OF ) <br /> )ss. <br /> COUNTY OF ) <br /> The foregoing was acknowledged before me this day of ,20_,by <br /> as of <br /> My Commission Expires: <br /> Notary Public <br />