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<br /> �e��tF:ottYt;;�;<; 500 Water Street,J-180 b
<br /> ��' -'"�`� ""`" Jacksonvi�le,FL 32202
<br /> Submittal Must frtclude Drawin s)and Review Fee(s
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<br /> Application Da#e: CSXT File/Agreement Number: �' �� �,� �
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<br /> Owner's Complete Lega! � "".:c; ..-.-;._... .. ._....._._..._,._,
<br /> Company Name: Gtty of Decatur ;, � _ �"-
<br /> Legal Address(3): No.1 Gary K.Anderson Plaza
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<br /> City: Qecatur State: IL Zip:�82523
<br /> Business Type: [� Corporation [� Limited Liability Company � Limited Partnership
<br /> [] Municipality [�' Limited Liability Partnership [] Generat Partnership
<br /> S2ate af Incorporation: Other Business Type-Describe:
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<br /> Coniact t�ame_ Matt Newell Contact Title: City Engineer �
<br /> ( O�ce Phone: {217)424-2747 Ext.: Mobile Phone: ��� �
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<br /> Emaii: mnewell�decaturil.gav Emergency Phone:
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<br /> C�ntact Name:j Cha�9es liunsinger �i��,;�..---�" - ��' -;-�;�- •
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