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Steves, Ernest L.
ORK NEWYd Viw STATE DEPARTMENT OF HEALTH _ Bunal - Transit Permit dYhl PeLrtrdn Name Fast Middle Ivt 5pR Emetl L& N LHp^t PoatM1 Fg H otllSRmNfvney %IOl10S BtYwa i Ww Waoror Gaps WxeoIRM FwpwM Insmmnur C' .iavmorYRm Gms Flln SpaYAMms wvu FeYlb�Y mannerdl>eam ® NmptCam LJANiFmY Uwam.im �sdax �wwepm,iped E]vwairM Unrtumsums Ims MmmW MNlral[enAer xame Tpe O Adams Vmgneea ENDdtlresi 1W Per gere Fa6 Nµ YUR 1R901 0.WM14ni1'wp Fled Wmn Xum�r P13 Numhe C ,Tavmorvil (yore FW �1 ]1] �Punat Im Eerte4ry.Cpmapry orFanlHy Name �Emmmbmenn % pmAmO e+ amm ddms O(remMun Dammam Tvxn Nan YpY �donaton Q ❑NemovM om Man Po� 0 a,dmr ar0x Had Had Addm, 0 6 pTran,pMwlon Dap lbimd S M1ycomm, %mam C,,wr asHrution ❑Olslmemarn Om @mean AWrcss ❑Relimmpm oah Umefty Addivo Pennll:mpdro mom Nomivr Nam ,[Fu altbm Maw,F,,miP ne mo adore:: to Gawpew Pomx]T, fmrmn Naq imnoxn Nameol Fumal firm MaFLgpspasnmwb WMm Hemainsare5hl IIUM1ertM1angb>.e Address G ParmNubn laM1wMby 9yaainal W dlHpow W tlw human mmelns tlamajima aimm m lnElmml. om Issued %N//+VN Pe®marW ViplSufns: RItM MIItw CWIS(ElMmnkally SignaQ 4pum21 Oinnn Numhr Man flze Gam FSK l4n Yw4 I Certify tAntM rtmaivd tan mndNM daniTal al emm disp M in a'mNm xnM1 Nls permiterc omol Xi.y,arn �Iv ly7 vuremrv,Pomio„ �„� �jL ..w mm.ri ..+.y (peieev 4M xn,edsem,wvanwtinai.�vremi..� r L ate/ si],mp rWe oxxasssl%hel Ptd] public HeaIW Law Sec. 4145(2b) 012649 Receipt Humav remains eFF�n/Esr< . siEJ/ESmu.ereaw �/ °l- , 20 -?O fC777lyxn-y nm�+m�lmu+ln®eo.mm� Z MCW xmwoovwn Res.a e