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HomeMy WebLinkAbout17-18827 CITY OF ZEPHYRHILLS _ : 5335-8TH STREET ` (sis)�so-oo20 18827 FENCE PERMIT = • PERMIT INFORMATION � - = -� LOCATION INFORMATION Permit Number: 18827 Address: 5802 19TH ST Permit Type: FENCE ZEPHYRHILLS, FL. Ciass of Work: FENCE/NEW Township: Range: Book: Proposed Use: SINGLE FAMILY RESIDENTIAL Lot(s): Block: Section: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-07700-0081 Improv. Cost: 4,550.00 OWNER INFORMATION Date Issued: 8/31/2017 Name: MORRIS ANGELA &WHITE BRYAN Total Fees: 50.00 Address: 5802 19TH ST Amount Paid: 50.00 ZEPHYRHILLS, FL. 33542 Date Paid: 8/31/2017 Phone: Work Desc: INSTALLATION 240 X 6 PVC FENCE CONTRACTOR S APPLICATION.FEES POST R US INC (813)779-7795 FENCE 50.00 � � � � �� � � Ins ections Re uir.ed F NAL REINSPECTION FEES:(c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or first reinspection,whichever is greater,for each such subsequent reinspection. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Complete Plans, Specifications and Fee Must Accompany Application. All work shall be erformed in accordance with Ci Codes and Ordinances CONTRACTOR PERMIT OFFI I PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER i • ACIME FENCE pC�qg ����� �����, 5150 Halstead Ln. E6A1C6 Zephyrhills, Florida 33591 "You�PYCSpecialises'2 813-779-7795 813-973-OB26 888-779-8553 fax acmefence@yahoo.com LICENSE # 11795 PROPOSAL/CONTRACT Page � os/21�aoi� Customer Information: Job Information: ANGIE MORRIS JOB LOCATED IN ZEPHYRHILLS 5802 19TH ST CROSS ST IS lOTH AVE Zephyrhills, Florida 33542 352-603-0454 annangie88@gmail.com Notes: - 240' 6 ' PVC TONGUE & GROOVE PRIVACY - 30' 1 10 FOOT DOUBLE GATE 1 5 FOOT WALK GATE 30' 30' GATE POST W/ ALLUMINUM I BEAMS so� STAINLESS POWDER COATED HARDWARE LIFETIME WARRANTY PRODUCT (MANUFACTURE) EXIS�INO FENCE �( ,2� � LIFETIME LABOR WARRANTY AS LONG AS OUR � a� s• FENCE SIGN REMAINS ON THE FENCE. NOUSE io� _� fz� 19� e 1 M ACME FENCE agrees to guarantee above fence to be job and adjustments for labor will be charged or free £rom defects in materials and worl�anship for credited at the currently established,rates. one year. Additional charges for any extra work,not covered ACME FENCE shall advise the customer as to local in this contract that was requested�by the customer zoning regulations but responsibility for complying will also be added. The full amount of this with said regulations and obtaining any required contract along with any additional charges will permita shall rest with the customer. ACME E'ENCE become payable upon completion of all work whether will asaist the customer, upon request, in or not it has been invoiced. determining where the fence is to be erected, but A finance charge of 1 1/2� per month (or a under no circumstance does ACME FENCE assume any minimum of $1.00), which is an annual percentage responsibility concerning property liaes or in any rate o£ 18�, shall be applied to accounts that are way guarantee their accuracy. If property pins not paid within 10 days after completion o£ any cannot be located it is reco�nended that the rvork invoiced. All materials �aill remain the customer have the property surneyed. property o£ ACME FENCE until all innoices ACME FENCE will ass�e the responsibility for pertaininq to this job are paid in full. The haviag underground public utilities located and customer agrees to pay all interest and any costs marked. However, ACME FENCE assumes no incurred in the collection of this debt. responsibility for unmarked sprinkler lines, or any other unmarked buried lines or objects. The customer will asaume all liability for any damaqe cauaed by directing ACt+� FENCE to dig in the ;+++madiate vicinity of knosrtt utilities. The final billing will be based oa the actual footage of £encing built and the work performed. Partial billing £or materials delivered to the job site and mork completed ma�r be sent at weekly intervals. Adjust�aents for material uaed on this ���,f C��' ApProved � Accepted for Customer: �.� �,�..o,, rn . �nn��� 4 - a3-r7 Contract Amount: $ 4550.00 ��P Customer Date Down Payment: $ 1750.00 A e e FENCE: Balance Due: $ 2800.00 ����� a on Date I I lllll!IIIII 11111IIIlI IIIlI Illll IIIII lllll!lIII IlllI1111IlI! a ` 20i7138933 ti Petmit No. Parce!tD No !! '�CJ��t'"'VV t �-��i �7�0��}�✓r PdOTICE Q�C04'AAEEt�CE4#9 Stateot 1 ��(`�I V1� Counryof C�,S�CQ ���Si�aocn��v���°rotav�me�i v,�r��nm�adelm�`ea� ,a ot�`�"3 �'t�"'����i zr��'i�°� 1. Oescr�tionnTProp��Y ParcelldemtfsaUan�•.s� �f" �W�"'� d�3 r GiK � sqx f'd �8.� sve�znaa�s: —S cS'�D? r • 3 S"12 2. General Oescri�on af Imp+ove,nent �r L�!� �t 11� C/��G 9. Ownsr Irtama�or L,essee Inlbrirr�tion I1 the Le3See contraded for tlie imyrowr�nanC �Q� A l �� �.S' W��° �- L r ' FC -�'..�St12 : �s'� S`%3C.z. !�"'~�'�. s�s� nea,� �'�' � m m c°Dc tr�tarest tn F'ro�esty: �'' •.• � � Name oi Fee Sa�e 7GIeho7der. � � N (If d�fereot from Oamer Ilsted ebave) . • aa,t� � asy st�$ ��� 4. Gmtractm: L . . ,S?.,.s"�'"o �a!�f'ta�, LlL•' Z ti r�l' � Ft.�'.?S�)�' 3 l51 A Addre55 CitY Siate tR r-+ GmUadm's TelepFane No.: � �6119 5. SuretY � K m Name t7 Address � �B �`p Amosmt ot Bond:S Teleptwne No.: � � 6. leMer: Nsme Address � �� LeRdEI'S TB�ICnB MO: 7. Peesons wiUsin the St�te of ftroida destgnateQ by tlte owner upon vAsom r�ofices or at�er doameNs rtsay�a s�ved as prov[da4 bY N ti Sepfon7t3.t3(tj(aj{7}.fiaidaSterittes: �� ' O`�� � �G,�b Name ��v� 7�N Q Addrms Ciry State �/��.�++m Telephone Numbei at Destgneted Pe�son: I V�/�"�r= & In edd'Aton to hhnseit.the wmer des}gnstes ai_ �(���-�+� to netatrive a eopy a(8'.e Liena's NoBCe as providgd'm Sectltm 713.13(tj(b),fFarida SlahttB3. '/��y++�N n Te#eptmne Ntmtber at Person ot Entiry�e"..3$t�ated hy O»s�er: !wd v�i � 3 c� 9. H�ira@on dale o!NatiCE af Ccmrnencr�nprt(the e�q7hation dete may not be b2fine the amGleUon ot cor�s�qron and final p2ymer�tu the � o tnantractat.but tki!be one year from the date af reeording utiless e dfffe+rrt date is specifled): �r+r�- WAR►dSNG F4 OWNER ANY PAYMENTS MAdE BY iFfE GIWNER AFFEtt THE£%P1RAR0lf 4P T11E NOTiCE QF COMMENGF2u2ENi' � pRE CONSIDEREO IN,PROF'�R PAYMENTS UWDER CHAPTER I13, PART f, SECTION 713.t3, FLpR1pA S7ATUTES, AND CATi I�ESULT IN YOUR PAYING TWICE FOR fAtPROVEMENTS TO YWR PROPERTY. A WOTiCE CI� (�.WMENCEM�NT AGUST BE ���+y w RECpRDEp pNp pOSTED OY THE J08 SITE BEFqRE THE FIRST INSPECTION. IF YOU INTEHD TO 17BTAIN FIWWCWG,CONSIA.T � WiSF!YOUR EENDER OR AN ATtORHEY SEF�tXSN&iEtdGt3G WORK OR RECORDSNG YOUR N{}TtCE pf COMMENCEMENT. �r+� I Under penalry o!perJury,I deda�:Ihat I have read the toregoing notice oi Gcmme�etnent and that the tacts stated there(n are we ta the best �f 17 � o!my Imowtad9e and bdieL V� G, � r STATE QF FiBRIDA rn� . � CAUNTH OF PASCQ re d�a��I�,ess�'S}Au�ed _ _ ORkArtOi�or7PartriedA�enager SFAnetmys Tltlelotrce i'he tarego{ng astrumera wss aclmv�eC9ad betrne me this�,day a1�.201�.by no� �C. �O�C C'. S as t��a�rih'.e.9•.otlfeer.Ws�ee.ettom9Y fn tedj far ({n�eme of paAy an behalf aT tN�tom Instrt�feM was exeaited). Pe,sor+atiy Knovm�4$�tde�ftt�t3an 0 Nctary fiignahu�ee�a�..� `l GR �„�,Q� hu ry�or iae�wuo�Ftoeucee r��ne ca�;M) ��c�x�+`�g�..._. `rt�n�-'r�4.. 1ANICE H.VARNALIORE . MY���n � BXAIR88:Octabs26,20�8 eryttta�lb�;ttroti�mrnencemer+tye6s30es •� •1 ��e ���`� ' Y ����� �MI��I�T�0��RT�1f=��AOUHE F REG�4S��� � OING I� A � ' • � TRUE AND GORRECT COPY OF THE DOCUMENT � �z ' ON FILE pR OF PUBLIC R�CO R D I N T H I S O F F I C E � � GpQ'We?r�t • � WIT ESS MY HAND AND OFFICIAL EAL THIS �f � �'�' g . ' �� ' � � DAY OF 2 �('� -' PA S. O'NEIL, CLER COMPTROLLER � ��� ,as7 0�. . � ' '' ' � ° p�� B�' DEPUTY CLERK ��'�3E OF�' --- ._�- 813-780-0020 Gity of ZephyrhiAs Permit Application Fax 813-7aaoa2� Building Department - J � Date Recelved � P.hone=Gontact'for Permittin i ' Owner'�Name � -c' /'�d��( Owner Phone Flumber ,_ Owne�'s Address � � t � Owner Phbne Number. � �- Fee Simple Tltleholder.Name � � �Owner Phone Number � � Fee Slm�le Tltlehalder Addre�s JOB ACIDRES$ �-5 V " '� (L� � � LO7# ��� SUBDIViS10N �� � PARCEL tD# � �j `� � �'�����l�~�7���—�� , _ (dBTAtNEDFROM,PRQPERTY,TAXNOTtCEy WORK PROP03ED NEW�CONSTR ADDlA�T [� SIGN' '[�� �Q� � DEMOLlSH � ' e� INSTALL 8 REPAlR � ' PROPOSEQ,USE [�] SFR � COMM L� QTHER '"" � ' TYPE OF CONSTRUCI`ION � BLOGK, " `Q FRPiME � `STEE� Q DESCRtPTION OF WORK• --x � � �� �C�I G � ' SUILDING SlZE � �"SQ.FOOTAGE =2'^�� ; HEIGHT���,�� QBUlLQlNG , $���—� � VA�UATiOIV,OF�'t'tJTAI:CANSTRi1CTION -! � ' , QELEGTRIGAL , ($ �� AMP SERVICE Q PROGRESS ENERGY [� W:R.E:C. ,� (� QPLUMBING� $ ` ` _� ��-.-� ���,�- QMECHANIGAL $ VACUATION OF:MECMANICAL INSTALLATION .����,,�i^' � , QGAS Q ROOFING _Q SPECIALTY.0 OTHER - ' FIIVISHED FLOOR ELEVATIONS ��� FLOOD ZONE AREA QYES :NO BUkLDER J��� _.._...�. COMPANY� ��p�Yt � —�(�<,'� '. SIGNATURE REGISTEREQ Y/ N � FEE GURREt� ' Y/N� Address Sf,�� �t ,� �� '�-2 License#'� � ELEC71tIClAN. ., COMPA�VY� � , ' 51GNATURE � REGISTERED Y/ N PEE CURREK��' '' �-Y/N Addre�s �� � � � � , , , License#•i` . � I f�LUNlSER ' . � CtaMP.l�if+lY .� SIGNATURE ' , .REGISTERED Y.I..N:� --;FEE CURREP Y�/N. , ' ,.. . ' � Address � ,.License„# � „ ----�. MEGHANICAL: � � GQMPAMlf ' SIGNATURE� ' REGIS7ERED , ., . Y../ N: .ry_.,s,�eE Cu�n: Y.l-N . . Addres's` - ' " ' ' - . ' , . � ,� ` , .. Cicense# �. � � _ OTHBR :' " . - � . � �;"C�}11�PAt+IY ` .� ` � r,:: SIGNATURE -. � � �"' �' ' � ` '`REGISTERED'' Y/'N:... � FEE CURitE� Y�/N Atldres� ., . >. . License#`� � ,,.,. ....., _ � �:..,�,..,�,: ,. 1:.;;�,r.;:.:,,. ... >;:,- . � , . � , ltESIDENT1ALt> : �Attaoh"(2):Plot<P;Ians;:(2)sets-of�8uildingrPlanst'(1j°seEof!Energjr?Fartns;'R=O=W Peririitfor'new'constrvction, "_ '" ��,:MlNmumt ten;(�1 p);�wrQrkingydays;,after;submittal`date.:.R`equireil onsite;:Con"§trticdon.Plans';°Stormwate'r'Plans w!Silt'Fence`installed, -' � �Sanita"ry'Facilitles&,1�4dumpster;Si#e;Wortc�Permitfo�;subdivisions/large�.proJects.�.:. .;:,;; . -. � { ,. , - ` GOMM�RCIAl. Attach(3)�complete'sets of'9utltling Platis plus a I:ife Safefy Page;(1}set af Energy Forms.R-Q-W Permit tor neuv conshuctton. � . Minimum ten(10)working days'after submittal date. Required onsite,ConstruoUon Plans,Stormwater Plans w/Silt Fence installed, Santtary FadiiBes&1 dumpster.Site Work Permit for ail new,projecfs:Ali commerciat•requlrements.must meet comptiance SiGN PERIVIlT Attact►"(2)'sets of Eiigirieer.ed-.Plaiis.; - �� �� , ' "•••PROPERIY SURVEY required for_all NEO;V constructlan.. . t ,,. Dl�eetlons: -. , - FIII out applicadon completely. Owner 8�Csantractar slgn back of applicadan,notarized if over�2500,a Notice of Commencement is required. {A!C upgrades aver 3T500) �.;p a,�t.r.'�•,� " P�qent{for the cxintractOr)or Powef of Attomey(fa�Uie owt�e�)woutd be sameone with notarized letter from owner authariztng same OVER tHE COUFiTER.PERMi1"fiNG- -- •(Front of-AppticaUon Glnly}- - Reroofs If shingles Sewers Servlce Upgrades A(C Fences{PlotlSurveylFootage) � . ,. . . . ;;, Driveways-Not aver Caunter if on pubtia roaduvays..needs RG1W ;� � � � . � ..:'. ', ;,^:':. NOTiCE OF DEED RESTRICTIANS: The undersigned un.derstands�;th�t:this;p�rm)f,:may:beesub)ect.to,tldeed"r,estrlctlons",_.._._ ..w._ which may�be:mbre�r:esMictive-th��County-�regulatfons:�-�TFie underslgned"`assurries���esponsibillty:'for4compliance witfi'any'"" �`� '��v applicable deed-resMictions. :. �.,..;. .. �. .,-. • _. _. ... . • ,, � UNLICENSED�'CONTItACTORS .AND CONTRACTOR RESPONSIBILITIES: If�the�owner`has`�hired��a`contractor or contractors #o undertake work, they may;be.;requlredFto.�be;�licensed In accordance.with state.and�local regulation.s.:�lfithe =' = � contractor (s=not Iicensed-as��requlred"by lew, �,tioth�the owner and��contr�acto��may�be°�clfed°for�a�misdemeanorviolatlon under state Iaw. If the owner or Inte'nded.contractor,ere_;uncertaln as to what Iicensing.requirements�may��:apply-�for�the'�• �� • < <���� . .. _ ._ _:... .:.-.�- - � - , - - . .,.�.. :, ,, ,. Intended work,=they a�e advised fo contact:the Pasco County„Bullding`Inspection,Diviston_-l:tcensing Sectton at 727-847- 8008. FurtFiertnore� tf the owner'fias�Nired�a con"t�aotor'or contractors. he Is advised to have the contractor(s) aign L..'.'r'i� � portions of the,ncontractor Block°_of this,_appllcation_for which_they wlll_be..resp.onslble: If-you, as:e#he owner"s`ign�as�the'` � contractor, that may be an indicatlon that°iie=is'noY.properl'y Ncensed�antl"'is�not entitled to pemiltting privileges In Pasco , County. � . ._ :.; �. ., TRANSP.ORTATION.IMPACTIUTILITIES�IMPAC�ANb RESOU�tCE RECOVERY�FEES:� The undecsigned`understands that Transportation Impact Fees�and.Reco.urse Recove.ry:Fees may��apply��;to�t(�e;constructtort of new,b,ulldings,°change�'of'���`'`-�- '" use In existing buildings,-or�exparist�n�rof�ezistin�:ibuildings; as specffied.(n Pascv�County O�dinance number 89-07 and_ 90-07, as amended,._;The understgned aiso'uriderstands; tFi.�t:'such fees,•;as�may:tie�<due;,,wfll;:be Identtf(ed at the�time�of��t� ---��" ' permitting. It Is fu'rtFier understood that Transportatlon Impact`Fees and'^Resource�RecoiieryYFees,must be pald prtor to receiving a 'certiflcate.-of-occupancy"�or�flnal�-.powerrelease� :If�the.proj�ct:..does:not involve,�a.certfficate of occupancy�o���-`��`"`� �� ; _ ... flnal power release;:the:fees`mu�t�be"patd;p�tor to:permit Issuance. Ft��thermore;�if Pasco,County°`Water/Sewer simpact • ����•,°�- fees are due,._they�must.be=paid:_prior to.permit.}Issuance�ln.accordance wltFi�:appllcable:Pasco',County-�ordinances. - CONSTRUCTION'GEN'LAW�(Cli�pter 713� Flor�da Statute�,as amended): ifi valuatlon of work is$2�500.00..on more,..l�� :�,�.: cerlify that-I, the•applicant;:�have��,been�provided with-�a~copy-of the=�"Florida� ConstrGctlon� Lien :Lav�—Homeowner's Protection Gutde" prepared by�tfie Flo�ida DepartmenC of Agric.ulture and Consumer Affairs. if the applicant is someone ,� , ,. .,..,_ ..a.., �. , � other than the'ovmer", I certifjr.that:l-h�ve.,obta)ned>a�copy.:of.the;abova;des.critied d`ocui�ent:and,pr.o,mise�in,good':f�ith�to ,.; deliver It to:the'owner"'p�io��to'=commenaemen#:' -� " , . .. � CONTRACTOR'S/OWNER'8 AFFIDAVIT: I.c.erfltjr,;tliat;ail.the,Information.in�thi�applfcation is accurate.and that all work will'be done in compliance with all.appltcable�laws regulsdng constructlon� zoning and�-land°development. Application,is hereby made to obtain .a.perm(t.-:Co�;d.o_work;:,and=lnstallatlon �s indibefed:-:...�1- ce�tify that no work':or installatton fias commenced prlor to issuance of�a permif"and that`.all work will be perFormed to meet standards-of all laws regulating� construction, County and City codes� zoning regulatians, and land development tegulatlons'tn the jurisdlction.= I :al'so _ certify that I unde�stand that the regulations.of other government agencies may�apply.�to the intended work, and that it Is my responsibility to identify•what,act(ons 1 must�teke.to be;in;complla�ce; S,uch:.agencles include but-are.not Ilmited to: � - Depa�tment of Etivironmental''Protection=Cypre"s§.`Bayhead�;�WeNand Areas and Envtronmentally Sensitive Lands�Water/Wastewater Treatment. - Southwest Florida Water Management:":District:Welis;' Cypress.� Bay�eads;- Wetland Areas, Altering Watercourses. � � � - Army Corps of Engineers=Seawalls,''Docks, Navigable�Waterways. - Department of.:Health-;,&.-Rehabilitative;,Servlces/Environmental- Health Unit Wells,=WastewaterTreatment; Septic Tanks:..``.�:.. . ' --- _ - - US Environmental Protection Agency-Asbestos abatement:,. � � Federal�AviatlonAuthority,,.Runways.� � _ I understand.that.the:following.�r`estrictlons apply to the use of flIL•• - Use of fill Is not allowed in'.Flood Zone"V"unless expressly permitted. - If the:flll'materlal'-is �to"b.e used��in :Flood Zone. "A", it. Is understood��that�a drainage plan addressing a "compensating volume"will be submitted at�ime of�permitting wh(ch is prepared by a professfonal engineer Iicensed by#he•State of;Flo�ida. = ��- � _ - - if ih� flll matertal-is to be used tn Flood Zone "A" in�connection�wlth:a�permitted building using stem wall , � conat�uction, I cert(ry that flll:tirall:be used only.to.fill the.area within�the stem wall: - - If flll material is to be used in any area; I �certify t#�at uae. of such�flll�wlll not adversely affect adjacent properties. If use of flll Is found to adversely:�ffect adJacent��pr�pertles,.the owner may be clted for violating the�condi#ions�of the building�permit is"sueii��under tfie`attacFied�ermtt-�ppl(cation� for:lots�.less than.one (1) '� acre which are elevated�by;flll,a�t engineered dralnage plan is required. . •� If i am the AGENT FOR THE OWNER,.I;.promise In good faith to inform the owner of the permitting conditlons set forth in this affidavit�prior to��commeracing constructlon. 'I understand theta-separate permlt may be requtred for elecMcal work, �,..,�..._ plumbing,_signs, wells�.pools;.air conditioning,-.gas�.or other install�ttons nok spec�tcally Included�in.the application. .A� pe�mit issued shatl be constcued to�be�a�license'•to proceed with tNe:work and�not�as:authoNty=to:violate;'cancel, alter, or set aside any provisions of tfie technical.codes;�nor shall issuance�of a.pe�mit.prevent th�Bulldirig Offlcial from theceafter requtring a correction.af eRors in:.plans; constructlon,or violaUons of-any codes. Every permit"Issued sfiall beaome•invalid unless the work authorized:by such permit:�ls.commenced�within sfx,months of�permit Issuance� or if work authorized by the perm(t is suspended��or;aba�doned�for:a:period�of six:(8)montTis.after the;tirt�e the�work is commenced. An extension may be requested� In writing;�from.tHe:�Bullding,Offlcfal for a pertod=not_to.exeeed'=ninety�(90)'�days a�d��will demonstrate justi�able'cause for.�the exfenslot�. If work ceas�s:ior ninety(90)cons.�cutive.day.s...th�)ob�is considered aba�doned. WARNIRIG TO OWNER: YO.UR.FAILIJRE>Tt1,.REC.OltD,A:�,�40TIGE�:OF:�COMMENCEMEMT NFAY=RESUlT IN�YOUR PAYING TWICE;:FOR IMPROVEMENTS�Tfl:YOUR::P#tOPERTY.=1�°YO.U;IIeF�E�D:�T��:�BTAIN�FINAf�1E1NG;'C.ONSULT WIT U D �O. Af��1TTORN F�RE+, ECO �� OU ' � � E E ' ' FLORIDA JURA��(F.S:t17.03}. . • -. � , - :" ' ^__ �____,--•— _. _- - -, OWNER OR AOENT CONTRAGTO Subsalbed and swam ta(or alflrmed)before me thls Subscribed'and' -bo(o afflrmed)�befote me ttii� by _ r�by- - Who Islare personally known to.me or haslhave.produced Who.ls/are p.ersonallyknown•to�me-or haslh�ve•produced • ' ae id'entlflcatlpn. as ldentlficaUon. Notery Public _ � Notary Public Commisslon No: Commisslon�No. Name of Notary typed,printed or stamped Name of Notary tyrped,pdnted or atamped