Waiver Form for
Requests
______________
(Date)
This form is to grant the approval of the building
committee for ____________________
(name)
to
_____________________________________________________________________
(purpose)______________________________________________________________________
_______________________________________________________________________
at his/her place of residence being ____________ Crooked
Stick Dr. Kokomo, IN 46902.
Signed,
___________________
Tom Smith
___________________
Justin Thompson
___________________
Brad Blount
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