Loading...
HomeMy WebLinkAbout21-1331 >e City of Zephyrhills M 8 5 Rx M 10 NUMBER ` . 5335 Eighth Street Zephyrhills, FL 33542 BGR-001331-2021 813 Phone: 780-0020 Issue Date: 01/15/2021 :. .. ( ) Fax: (813)780-0021 Permit Type: Building General (Residential) P.rop�ertly Number Street Address 24 26 21 0110 00000 3070 3108 Lytton Hall Drive Owner Information Permit Information Contractor Information Name: FARON ACHZIGER&ANGELES Permit Type:Building General(Residential) Contractor: POST R US INC JANETH Class of Work:Fence Address: 3108 Lytton Hall Dr Total Valuation:$4,295.00 ZEPHYRHILLS,FL 33542 Total Fees:$65.00 Phone: (813)966-2542 Amount Paid:$65.00 Date Paid:1/15/2021 2:04:38PM Project Description INSTALLATION 221 FT X 6 FT WHITE PVC FENCE Application Fees Fence Installation Fee $65.00 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 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 permit required from other governmental entities such as water management, state agencies or federal agencies. "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 add fee Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. CONTRACTOR SIGNATURE PE IT OFFICE - - PERMIT EXPIRES IN 6-MONTHSWITHOUT APPROVED INSPECTION — -- CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED - PROTECT CARD FROM'WEATHER I INVOICE0000 - - . FOR CITY OF BILLING CONTACT j CHRISTOPHER DAVIS POST R US INC 5150 HALSTEAD LN ZEPHYRHILLS, FL 33541 i INVOICE NUMBER INVOICE DATE INVOICE DUE DATE INVOICE STATUS INVOICE DESCRIPTION INV-00002446 01/12/2021 01/12/2021 Due NONE I REFERENCE NUMBER FEE NAME TOTAL BGR-001331-2021 Fence Installation Fee $65.00 3108 Lytton Hall Drive Zephyrhills, FL 33540 SUB TOTAL $65.00 REMITTANCE INFORMATION TOTAL $65.00 City of Zephyrhills 5335 8th Street Zephyrhills, FL 33542 �I I I i January 12,2021 5335 8th Street,Zephyrhills,FL 33542 Page 1 of 1 :.r ACta FENCE ACME Acme Fence 5844 1ST ST FENCE Zephyrhills, Florida 33542 "Your PVC Specialists" 813-779-7795 813-973-0826 888-779-8553 fax WWW.getfencenow.com i acmefence@yahoo.com WORK ORDER # FARRON & JANETH ACHZIGER 3108 LYTTON HALL DR Zephyrhills, Florida 33542 813-966-2542 6' 72" high X 72" wide WHITE PRIVACY TONGUE & GROOVE Fencing Customer Availability 59' cost of line to share 1300.00 Locate # El 66' 72' Buried Lines ❑ Cable HOUSE ❑ Gas 5' ❑ Phone 5' ❑ Power i 1' E ❑ Sprinkler 13' ❑ Water N+s Permit ❑ Customer NOC & PERMIT ❑ Company ❑ N/R Utilities Available Job Notes & Access Info Fence Line Layout ❑ Water ❑ Owner ❑ Electricity ❑ Company ❑ ❑ Equipment Fence Line Clearing ❑ Power Auger ❑ Owner ❑ Nail Gun ❑ Company ❑ Cement Mixer ❑ ❑ Compressor ❑ Bobcat Post Hole Soil Disposal ❑ Jackhammer ❑ On Site ❑ Rockdrill ❑ Haul Away ❑ ACHZIGER.JPO 10/19/2020 i AXWN ► tea.mta��a�cauaas e�w ra�yo`�e�aw�ts�pauN ; a 2 uo 11 au- _� kP � Z£9£ZE°JJON VMft M.,7 : £ZOZ'81ludet d Pa�oWNsea�'t=os=9�wOm 'in dna � isal}�j'tUiLQ'.� Wi A.S ? d1 Davis 0 X7Nn00 Ts�4e+Gal�4aieu�BP �3e4lI�WP�7 �+�+�30� +�3+�BP�+�+117e+A + �Wfl 1'Y19QDp�E}t�Il�L1�t�NAfS6 Q�S.CtfipJll�'',�pl�S2lkt3it � ii�����lyfdQt�VtT�tlO N�fJ @�N b91f111/,lS tl0�13'E1'lELt1�1�0t1�39 `6LLA2HSdN�9�811��I1R► tSicf�fif � . O dC13�11+ON�i1.dd N�IJ.Vl11d%3�tf.t13L•N 2B�1Nt0 3LL A930NN SL1+EHi�itld JtNV 2lTWYD 014X�12NM $P�.F�sS�i+ Bswlmt8upuo�A+�P�G�l��e4�in4 asp a4 maP"Lqp xwm jo Vow#=as amen atl-Am am BORooft so woommumucojo O*m;p wp a B setwip kt P�!Sa0�=o�d;p�N euo4dapj %arm F3TAMt-cm Wt !uoemm%manMaiomoogeyemm is P=awn ait � at B �+dPm�0ie=a4ti�t auoydafaE a Am ssaSPV MEN aPPa�'ttHaHt1¢t'Ett a� t4 Papr4sd Se pwae aq AMU Spueumaap Jamacl+e Souip too"uodo=amen a*14 Papua"appal P aM 04%WM U-XW z :aNauWa►atshwa't 87e1S AD MWV OUIM '9 "aNeaw#a(Bl S=Rp81u�W aatq� a 5 � =axis��ao `z hS;S:S sue]► 1 :4odwd w.;Nmu! am SSawV i �+e�aatt3Paersa7aNIIa !aessai wtauaA�4BUWO I e�. 7 s�►. ?R"Jof timt rJ aardvae�Vwda c 02Ov£oagav Get r+lzarG#+z�Ioa+Wtls!giaP $1a4B�a4l 's�,a�'£tL >ra"awP�'1lYadmdiaalupawgtapewaq�+maara�xngaapuSanlBk�a4Ca�YJS2i�Yi�. • Pam t t t�tpmed Vied I i I aalloaldW03}g ltaa»dluno3 oasBd`ibs3'sajnnog-zaaanjV NMIN =' 00'0'll 00'0:SO 00'Ot:Oea 096Z£ZZ:tdol:{ M 6£:60 OZOZ/EO/Zt t40 t eBed ��Z Od �zZQ� Ne ao 06£OZOZOZ#HISNI �*r I I Of past® o� _ °• �`� State Of 0lorlda,County " ®°A This is to certify that the foregoing is a true and correct copy of the document on file or of public record in this office. �,e7rust Witne s my han and official seal this �tG �•.... �day of 2 Nikki Alvarezpw s.Esq.,Clerk&Comptroller Pasco County loda Deputy Clerk F •, 813-7e0-0020 City of Zephylfiill$ Permit Application Fax-813780-0021. Bultding.Depariment� . , �d'ate tZecelved - =' l Phone.•Contast.farit�lninitting:i .. I;al•�'t'',"ri:':• ,' aide t• `•'S T: f � J .�'.r, ail�..: ._ _ _ r r,. ,atOFl�st�ltl��i$��: s,.,.,...>�...oeri::�'��?;-i�',7•Cc"J_::; Ago ow t''` z; ne s�AddPes� ''L e�; eet?�Irlton�IVittritber: ,.'. Feo''Sim 1o�7itlaRoldeFlJaiine P �;•. ,O!uvi►ar Phnii.®jNurstier. _ _ y Feo'S1rim le':TttleholderAtl'Vd-di: g, 1`'7 : i✓'• J', P JDBrADDRE$5t �6 ilk • / SUBDIVISION-: t: 7l.c� t !d6TAN0 ;#ROJYt'Plt4PER1Y�F _ tiYD 9 a c'. . RICP,.ROPO$ED'' ,. , ..� ,Nt:1N.CON 'D / .s•�•�. : STR, .s:ip� R,ALX; -..,, �'',• �StGN'r<:,:< ��''""''''�� s;DEMQLI$N', ,.,,. :f '.-'.•.. r ,?..�...,.:�,INSTAGai:.;•;",,:.� �REPAII,�, >5,=• ,y.lf -,a�•�.y� 'C ,) '•T•°i ,,I"i 'r 1�.` 'PROPOSED:U5•E-� - _ -;.. :;.;• �•'3::;;.. �•..,.r'=. rSpR.. .� - ,'CO3UitUi'.,:;'' i�;§--'t .OT#;11 R.�.'`: �:��;;�-;�s�:-�.,�; �x, .:>t-.•::;z�x�_ :` = .k.,r 1 irE'6F.C ;rt '✓`- . .i•,,•}',,;�,. i�,•..r .i'. v. }1',. (ti ':r''? .F,,;.,'::.y,.r,'�,>..+'.':/.�y n;wy•,n.� ., .r<,:yVFI;"` . - .r rpNST t1C'�IO.t�; i`,,,"'�—�. l�:�C�C; •�-- .;;" :.���iA?I�%: �. S�'E��LG._ r�a��r '� ���.. _���..-•':,,,., �,": y: `' ;;r i o �.Ca 7 .Lf DESt:`�I`I��° ORK°'' 'Y l.c:+' I. Bulk DIN `;$IzE�,' :].*.,S,olfn&OTAG Hrq;Y pp •`•` .rq ,tl'•� 'J'' :(„:. �f;, .i 4'..,: ,], i -li '•rt 't`—rA:; �'�� - �)= Aft•'•- L: .vnAr .,:?i:`,. - "'J,4*' .ii; -.F. a3.a%' :.;...::�-_:y::. -`f�+•,'rv, BUR iN - - _ iYA1zUA,OfV OF,J1;0'1'�Q1ti;`•:C.ONSTRUCT�ON::`• „= F'�SE.VICEt.,'..� PR SB�EN ., �..t' ,.. +t: a i,�'' -- •-t - - _ - .r. r-.i ir MECHANtGAL �lAt. O '� ��, s.•`,' ' "`::.':,}' ' '.` y�' :.: / - y UA N'tOF`MEGHANI { fi -77 [ GAS Q ROOFING .:4;{i:SPEC1A121Y„ FINI&6,'0fd6 ELEVi4TrONS `r" FLOiJD'ZdtJ %Ai2 ►` ,'�; _.r 1? s ,: :r t�iQ ' 1" h� BUILDER COMp'AI�f g SIGNATURE =sss t i 'I:'?f3EGlSTER IS';E= s /aaN;c '; 'P EE C YFW , i:K•'F'r 'cAtldre'a"sw ,` ?;i7;:/''Z:. '� v�'-'=��+�, •i '. :tiCens�'� ;'� �I..�. ELEt+TRICIAN��' .. - , , . -.:CAMP' �`ir;',:t',;i x.k; ,�::t. ..a :,`-`i:r;;::a•:' _ 7. SIGNATURE iE Cli.RiEky' .. -77 t ..L. ..a ,t,.t.. •, - 1, 1}; ., i.i.Y,.� :.ivi'.,.. •,'i! T s PLUMBER.: a w , .CO.MPANY•;._ S`I6NA7l7RE ; "i2E STE l:...�i !?.... t MECHANICAL', .i 't at :. - :.. i'; j.: '�"" . �$IGNbTURE.,• [tE STER D Y}!:ftf FEEtCU'. k YGh r{ .1 a Suit:. :Address•. 'THER `CCIIVIP :.s`: ;3'' '• ':':r'- a IGNATURE` -"12E�IST��iE1�'' Y'/-;•N''S , ECURF3ER' fYF/s"[�I'r*ti - •i' �1 WeA`48 .i�' - 'tom-%4a. :;'�•' i-`i7:. ..fr :,+- ,a, i' 1' 2 'efs_aB`)dri•aP `aij's'.. ..`1;t f` It' ` o. s ns' ti'•v :.z RESIDENTIAL Attacti��)�'I�, lans;�{,):$ p _�;.: �,�..��a..• ��;: •!�'!. � �_ �. t�t�e�+:�o�.���., + ,,`,N Minimum•ten'(10).woHcing'days.8ffer submittal:date. Ragiiireil:or(sife=.Canstni4tiori Plns,'Sf6Ymwa3er.Plan�S uV/.`Siitince'Iiistalleil7 N4 SaniforyFadliBes&t durnpster;Site:Work=Perr%�ftfo .sutidiv1st iisttarg8.pr je�:ts COMMERCIAL AtNach)2 com iete:setsaof:Buttdl //�`,.P. tOns-pTusra; to S afi", ?a'��yy'i3ri=): etof J=nergy:Forms.RAW R.®rmit.fbr,new: tistr iatio :Minimum'ten{10)ivor id �baysdite�s�' r i tti8te. 'R1 61fed site,Cbnstnrctlori♦ 1 �5s;sSi tmvvaf8rs !landyiJlp i F` q tihit*"��ed s SaniteryzFdllUdS< =>;du�ttpsterr.Slte':WoriPerfri :foralt:new rojeds All'cm. eicfaf` uire eh t ustrii {itin' SIGN PERMIT AttaCFt(2);s`ets�of, ngtrl8ered Plans: rr, .RJ. —PROPERLY SUkVBY'requiW foratl-NEW�consttucdon." 'f)lrectlonso-. Fill outF.applieation'completely.. ; turner-&:Cohfaotor-:sign Back of appiication:'natarizeii: If oirer 250.O.a;Notice,of Commencement s,required,::_(A/C:IipgSEld SioYe $7500. R ent(for.the.contractor or Power of Attom forthelowner:would be someone withtno'tarized letter from owrier:aut#iotiilo :s8me. OVER•.THE COUNTER'PERMITTING r,iCc py:bf,'Oditact fid ulce . Reroofs-If shingles Sewers Service Upgrades A/C Pe,noes'(Plot/Survey/Footage) Driveways-Not over.Counter if on pubiioxoddways.:needs ROW NOTICE OF',QEED�RESTRICTIONS::The undersioned ur deisg rids.that this permit.may,be-subject to"deed"restrictions" which rmay ii more-restrictive°than oori#3t regulations._-The.understgned;assumesTest%. nsibility-:forcompliance.with:any applovoi,das' r s,trlctipns :.... 5,, UNl:1CIED"CN1`RA�CTORS""`ANDCONTRACTOR` LSPONSlt31LIT1Es:� ifithew ocaner..}has.fliiredA'a contractotrhorrt t:0 t a t rs#o and rtatce°:work- he" is .,-e& gUired to.•�e licensed:irt:accorcfanee:with state.arsd_iacaC-regula#ionsr-Y:7�#�ttie.: : contractor, is not"Itcense t ac requtfedYby,law;,both'the:bwn'er::and`contractor~ma" be ci,ed=for Wmisclem'eanor violation under tat •:If:the owrrec4gr, InteneettFcc>tat�actot are tncai tain.as:.to:what licensing,requiretnerits.maYpi?1Yte #tie, ' intentled'Tniork they are%advisedrto:contact ttie.Paaao Gounty Building lnspectiori Division=Licensing•.Section at'T27=847- 8009 `FUrther1110rer:if?the:_awi}erf: as Bice t!a�c++ontractor•.i or contractors,"he is:advised ;to-_have the<contcacto!�{01•t sl9pv, portions o€#he="eootractQr 1319ck"`of.fhis.;aQj tic, ott�fQr viiich #tiay wtti.40 responsible. If you, as the-owner..•sign as the ccrptracto ,ahat:may'be`anindicatiori,that:he;;.is:not properly•licensed•and is.not:entitled.to permitting,,privilegesk.inTasco. TF ANS'ORTATIDN;IMPAC,TIUT'l:ITIES�IMPACT'''AND RESQURCE''REEOVERY;FEES: The'undersigned understands Y' tli4*40s-0ratid-w"lrtiib", eSant 2e�:o4�rs 12e.',coyeCrFees-may.appty�-t Ahe=constructionof:new.:buildings;ihigi'gwof�` use in:exisfing#uildings;.',o"r expansion;of':existing`building`.;,asspecifed ii Pasc6"Couriry'Oriiinance number:89=07•arid' $. . 90=07,',;as.amendi d:FyT e u der, ga Ad Imp, rstands;.that:si cfY�fees;:a <maywbe':clue"W-iJl.pe,identified at'thetitime�of�.-:.. pertnittin .,,,it;is fiurtlte *u 'cfet+bdf"fifF`rarisparlatiorti.lipact Fees,and;Reisource Recovery Fees. must:be'paid'prior to g _ ,- ".' t re,eivino;a.-0cert(date of pccupancy"tot-..-f nal;' o'et releas$: if ttiµe fprbject+id4es:� oh involve a:certificate:o€;occupaiacyaon. . ,i firiai.powerrelease;.the€ees must;.tipa�d prior#o:permlt�sstiariee."IFurttarmore if'"Pascoouty Water/Sewer Impact fees aae;:due•tl e' musttie:a'id :riot Co,perch'it ies�uance'n accorilance-Withf licabl6iRasco Countyordinances3z sir :Nxt l y t p Cho 't` r^7a13'` !o i!a St`atut+as a$ m-pridae' 4`lf�val at on ofwork'is' L5OQ-00 Qr ore,. ceff' #tSat'1„ ilia°:`opal,cant; i a e been>pxovicied rwif#i°a+:.:copyc ofi:cite::::Ptorida..Constructtori,:Lien .law--Homeowner s Protectigrl Galire°pra*Pareif'.byi1he'Florida D' pariment_:of Agriculture and:Consumer.Affairs. If tlae appijc rrt;�ia gs agile;., other'#hari;°ti e`-owner';tcent6_`!Lfl`at l s r abttair eit- i=copy:JD-1h ,-,_"V escriised„doci t en# Ind prom s' .i goo f t{jy deliver:if;to;the:".owr`let";•prior.�fo;conimencameet;;;�:: - :-At~ _I5'_�/tTw,'fit`k t:aii' 4,�• CC>N'fR;A OR-1Q C1Ytt' !2'S:, ,.F 9A ct: ::tha. ;j,..the jnformation'iri;;;t is.application-is�accurate-andAth' f1ilt viiork' J.i.p.t.. ,s. y; �.. .S,.y'':a-: :•L:: '-t! -t'. - +i,�t. '• :.s - ::i•: 'I;i-.:.::;»-;r:S t'tS�r:r will "i fh;a I;a iica�le°'laws re u1atin canstrwction gyp: P t �h t e done in`compllanca pp g. g.;,4 ,, ng:and=land'deiveio ment :Af�plicatiara is oh hereby:made to:,oi�tain-:a`permif' fo do«wbrkrrand iristalle ioit7'a thdicated,, '•:'l certify that' no`�work: or' ii,`Gllation-'has comtnencod.:prior=ta:;issuance,of,a pofi+riit.ai d that:aii:wank wild.be`.performed=;to4meet;standards..o€all laws..regulating: ,,.._ f �, cons'',wd"tiori;`Canty."and it `. des oning regt,Iations;anti:�ian de0lopment':regulatioris'.�riathe jurisdiction,:l,;also cart* '.4hat l miclerstar d that#die reoutat6h .of:other auernmer�it.aget odes mad appiy'#o.,the.intended.worii, and#hat:t is my.responsibility:to identify,what;actions J must take:to.be:irrcompliance. Such agenctesinctudebutare nottilirii(i;:#,q:' Department of EhVironthentat-}Protection=Cypress i 6a heads;-Wetlarid..AreIs and Er�vironmeritally 5en'sitive ••Lands;::WaterNl/astewlei '+zs; nts ,:;,i :.+,t;:r ;.; ,` 3, �. v: �,; Souttiwesf Fio tda: Water' tU,arte�emettit Dt00,11Wells; `'Cypre`ss 'Bayheads, Wetland Areas,' `Altering Watercourses: . - A ii Carpsof'Engineers Se;�wajls :ocks,vlyavigatiln:W terways: D:epartnnerit:ofi; #e ItJi 'A,# eta iiitative:S�n ice.,E6.Vironc"nei6t6l�Health;-7Unit4Wells, Wastewater;•,Treatm�nt,.. • Septic Tanks: .. - . I - - u � rivroiritat#?rateitio. ► �staabatgrnnt :: ,. : . .. .... .. , . ~�. . fedecayvatioi-�Ai�tfiorityr=��iiirvays '_::•.:` - - .. . uriderstand':that'iher€ollowir rastFictiens, theusewgfrfll�'' Use ofLfiit isrt iofrattaiiG c'Ii3 too ZQr a iT"'Uhldta Xgresslylpermitted. ff the #lta4eriafiS:to be:::iseiiri Mood Zone="iti°;'"it .isi�ndersfooc# tliafi aAdrairiage tilari addressing a rmPelriaiig.VlumeKuuilCabe:sutiriiitted.:at#irrae,•of=.permitting:,.wtiiCh•is prepared,by,a;:professional:+ ngineer M lythe State�of=�lortda: .,._.._. .,..,_ - =- : -.: . ..- . .. . .. -. :,; if<the:ftllr natertal.ts;tb<•be:used.iri::FJoad:Zon'Wi I lnaconnection'with a.permitted:building using sXe.( walls 1 . cons#r i ij(:`#i'e:f it only t it0tt<#t a area uvitt 10,'A i §tem.Wall.. L if°'flIl :metetial°is:#'is .anyaiea;. t certifyMthafuse of'sucF: fill Vli~riofi~adversely affoct:adjacent :prsi ertes :lf_aase.;of tilhstot}ncf.'totagversely<'effetaIjaceCjt pr, paiies;::die:ewner_may-:be.cited.;for violating p: r tfieYcoi tlittons':o€'tlte tiiiddint p fmiit i' rietl-.tint ec the 1i ':+-i`a�pemiitwappt tea tion foi�tots-tess'#han one (��} .sl.,rr.. .. ._a h,ek. r, @_. tl n n aced'di fin` e° la iS required. cre'>w,.i t :a el uata. f.. !X91._+ '. q if f am:the•AGEN' k Gf HIMWNER f' r ntie--,iti gt od=fa tp:t fit rttrt ih ��ow.,er pf the,...Perm!tting-conditions set,t6tthflri'=� y, ,:. this;affidavit;prioc,to,::'cornriienctr ,,coristrtiction. I uriderstar d i< at-a se orate'" ecmit'"ma tie:re` uired"'€oi'electrical.work, . . P,.. y q. luitiia i ' ris µwells`"`Dols=-*a .coiaditiQnin as;:or-other=ahstaltations-not'-spe�cifcally.aincluded-in,:the,::appliGation' A P _ w:n iter,'or permit-issued sFialll:be`construed;ta:be.a:Ilcense.to: coceed wit j;the•work`and.not:as;'authority to.violate;eartcet,:a set�asi'ie:arly provi iii�is�of;t#ia tephraiaaiFAcodas;�nor•ikiiil:issi�ance of:a permit prevents the'Suilding Official`from fhereaft ri tans'cc'it tru tiorr.or violation Hof, :an"' odes Eire• ' tir'it tssiied sltalt:become id lid`"' sprat. ng„a etstreotiri ...,.:e.;o....... :.,p- ... , Y.... fY p.,_.._....., .., ;__...:. unless;lhework„outl;orized',by;sh;R rmiYis;cammenced within sic month s','of;permit'issuance, or:if work'authorized,:lay tEiererxrilts'staspeei"dad orbantlon�edor:a peiod=of;$ix.46}irioiittisftettae zirri #hework is camt�ienced;:::An•etdnsion may°,be.;requeued;:inwritrjg,;.'from�'the;Building;Ofticia7.far; ;period not to:exceed`riinety{90}.days and will.:tlemonstrate. F•" jus# mile caaser€oche eitensirai lt-vrorkceases for ninetya0�consecutive days;'the j6b1s considered abandoned:_-; W. NtNG.TQ=QWNERc, YOU.R:�F'� U�tE`:TO`RECORD;:'aIVOT�CE,.4F;iCOMMENCEME:NT:.iVIAY";RESULT'II :Ye,;UR: PAIN: i1vi �- R11.�w7�w[tMEMST :'■Ir�"�;KwiPROP ,THY,;iI'�iOt� �l■jj`*� 'C4'OBAMN i I(`{'AN �l��i_ ; {A![V :Tf..,.:. t, .':'1??, - -^^;.{' 3'.`;,. t :- `�3. ,.i4. ,`r - —�t1RITRY. ti 'i�: l.DE_2R, �Atil- a�OkY.5t3lvF DRIE" COIRDiNG`�YOUR`` F:C4MtrM:�N�EINENT: j Fr-ORIDHUUBATiJR8'i:a1T'R3)';: ---- OWNER RJ► V '?._^ s:i. Qti rv4 c' kGQN7RACrX1�R•' Sufi 'bedr nd' :.oc{'itig7r' i ,iiie I :� r . Siiti b and c ' ed=lief to,m'.eah7s: sc�.• ..a ito . . 1)=nt4,. .s-t;: : :.,,: .. .. t. :. t... atfiim ;•.).:.. ....._.. .. w ar e'—oneil'.'known±-,to'me or.has%h"ave rodf5ceti" Who blare erson�tl .khkivm^to'. 4 y* Who,is/ e:p y p p y mewo�:h /tiaye:produ" as'identificatlon. I ': aIdeittiflcatloncs' '`''' Notary Public Notaryr.Rublic z ` ' Commission No. (?ommi ds'Iowlslo.;:;�: Name of Notary typed,printed or.stamped' Wme:ofNatary�.ty ed P�ititeilxor staffed