STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

)

)

Petitioner, )

)

vs. ) Case No.

)

Respondent. )

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PETITION UNDER THE FLORIDA CONSTRUCTION MATERIALS

MINING ACTIVITIES ADMINISTRATIVE RECOVERY ACT

1.

2.

3.

4.

5.

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Petitioner's name or Petitioner's

attorney's name and Bar number

address

telephone number