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- 2 .. <br /> THL ISSUAIXL, of Permit 140. __ for the above gamed premises by the <br /> is APPLALLD because: <br /> List games and addresses) of adjoining roperty owners: s� <br /> Signature of applicant Date , <br /> Action taken by Appeal Board <br /> Notes: <br /> Signed ��-�?Ce � eA�-,� -' -- <br /> --4#al�rn , County Board of Adjustment <br /> i <br />