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Safety and Buildings Diana <br /> 20I W Warhington Ave, c <br /> PO Box 7082 <br /> Madison WI 53707=3 't <br /> Phone: (60$)161-$500 <br /> TTY: (608)26+t-5777 <br /> Pax: (608)267.0592 <br /> PM'RICR DONALD KALSCHEUR <br /> 34 NFWBURY CIRCLE <br /> MADISON WI 53711 • <br /> This is your Certification, License, or Registration Card. <br /> i ' 9e0407 <br /> PATTtiOK . .,: <br /> Callikallos, Ryiinidee tipkis <br /> POWTS ,- Registration 03127/00 <br /> I I <br /> 1 <br /> Ii, <br /> Wisconsin Department of Com =rce <br /> IL grams' <br /> Cut around the ca to remove it. Sign the card. <br /> The card should be signed by the applicant wed.ye may apply a pmiecrive plastic (available at some <br /> stores)to the card. Preset the card to - requests proof of isisaaoe. <br /> This and should indicate other Department Comma=certifications,&tear or repallatioas awn*hd4 <br /> all previous cards that have acatificades, s • or repistratlon merry trhich aim appears on this cad. Ms: <br /> MN*categories WSW oa the card. If- • or discrepancies are famed,Picot contact the Castanet Service Carte: <br /> (CSC),606-2614500. Be prepared to OW CSC represeatsthe the Id tuber printed on the and The CSC should <br /> also be notified&chaag s In address as occur. Natifwtioo to the CSC&address chewBes is the reeponsibility <br /> a[the cedtficasioa,home.ar re altrad a ' - <br /> A renewal carte will be moat to the last - on file with the CSC at neat 30 days before the boa date of each <br /> certification,home,or r e g i a a u d o s on t h e oat Renewals are ooetinsant aeon compliance w i t h the require- <br /> meats specified in Coast S,Wimoasn n • I Code. <br /> The Deportment&Commerce is an equal service provider and emplerr. If yea need aaistance to aooe3s <br /> =vies or nerd tonetfai to an Mcrae* pima contact the depattme:lt at 608-266-3151 or TTY 6011-2.6447-_ <br /> -_ <br /> MD-10183(R IUd9 <br />