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Home My WebLink About06-5299 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT SINGLE FAMILY RESIDENTIAL 5299 Permit Number: 5299 Issued: 1/06/2006 Permit Type: GENERAL BUILDING PERMIT Class of Work: 101-NEW CONST/SFR Proposed Use: SINGLE FAMILY RESIDENTIAL Sq. Feet: Est. Value: Cost: 250,000.00 Total Fees: 4,218.83 Amount Paid: 4,218.83 Date Paid: 1/10/2006 Name: DREAM HOMES OF PASCO IN Addr: 5522 GALL BLVD ZEPHYRHILLS, FL 33541 Phone: 813 788-6800 Lic: Work Desc: SINGLE FAMILY RESIDENCE Address: 37311 PICKETTS MILL AVE ZEPHYRHILLS, FL. Township: Range: Lot(s): Block: Section: Book: Page: Subdivision: SILVER OAKS VILLAGE Parcel Number: 03-26-21-0200-00000-015B Phone: MECHANICAL FEE WATER CONNECTION RESIDENl FIRE IMPACT FEE RADON WATER METER RES 3/4" PUBLIC SAFETY 5% P 33.28 SEWER CONNECTION RESIDENl 180.00 POLICE IMPACT FEE 26.35 1,616.00 254.00 f) ,. cv~ DltJ y\0 \,)'l{ I 1 DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED LINTEL PRE-METER WATER SHEATHING FRAME MISC SEWER MISC INSULATION WALL MISC MISC. MISC. INSULATION CEILING MISC. MISC. MISC. DRIVEWAY MISC. MISC. REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections called d) work not ready for inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible. 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." O\<'6r~ ~or\) ~ ~ C NTRACT S SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER .' ~/ CI~Y OF ZEPHYRHILLS PERMIT APPLICATION BUHDING DEPARTMENT 5335 8TH St, Zephyrhills, Fl. 33542 I 813-780-0020 FAX: 813-780-0021 l~ I.. I~~ " DA'rE RECEIVEP~ I l60b /::5 e an', () e.. I PHONE CONTACT FOR PERM.ITTING f<3~- (o<6on .. OWNER'S NAME G ~ \-L) ~ Q...,)) S~. ~'S C'v\., Y JOB ADDRESS 313 I I P'CJ~~) )s M,\\.A.... R\ PHONE ~D ~ ) z,f:~P\4y~ N\\...L<">j-F l- LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION~\""\)t~ ~~~ V)~ PARCEL ID #0'3 -..;( 19-~ 1- C)~~O ~ C) OC~~ -0\5.B (OBTAIN FROM PROPERTY. TAX NOTICE) WORK PROPSED: ~EW CONSTRUCTION o ADDITION o ALTERATION [J REPAIR o INSTALL DSIGN o MOVE 0 DEMOLISH PROPOSED USE:~L FAMILY DWELLING DMULTI-FAMILY 0# OF UNITS o MOBILE HOM o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL DESCRIPTION OF WORK \0E. LC) R.-E. 'S \ t) ~ ~ c:...S BUILDING SIZE SQUARE FOOTAGE HEIGHT ~ BUILDING ~ ELECTRICAL ~ PLUMBING ~ECHANICAL RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. i> O)",2~\-- _(\~I Su.bs - S\C)Y'l f~fY\J, PERMITS REQUESTED ~('\~iNOC. - if'nlSS'c:\ v/' J)l~\~.- - $ ~,5'"DJ 000 ,,~o VALUATION OF TOTAL CONSTRUCT'~ON ~ - BD- .../ ~~ ~ AMP SERVI~E 0 Progress Energy 0 W.R.E.C. o GAS ~OOFING $~j~~~ ,~~ o SPECIALTY 0 VALUATION OF MECHANCIAL INSTALLATION OTHER TYPE OF CONSTRUCTION: ~LOCK FINISHED FLOOR ELEVATIONS o FRAME o STEEL o OTHER IS PROJECT IN FLOOD ZONE AREAD YES ~O 'it ff:-r-t....~T .......-,....." ,rl~- - ~--.,..,........-,~--..-r--~..,., ,-,-_M_ -, ~.~ ,- 'r- t - -r----~--~ - ~- - - ~ ! - f"C - - --, -- - -~~" ",- M -,..- ~TT"C:---~t:';;:";"':rT....T'" m I I I I' 'I r , I I t, I. 1, II I I I It' ! ' I I 'I I I ~ J ~ I ~. i ~ r!~~.~_~~..~___I,.~~.~_~~~__~_~...~.:-_~------ ___ ~~I__ _.~l___~~~-l....~' BUILDER ~ SIGNA;U~~ ~. . COMPAN~bs~N\ Not-J\S's c'F p~("~ H..)I::J , STATE CERT OR REGIST # G ELECTRICIAN SIGNATURE ~~Vi~ , COMPANY ****************************************************************** PLUMBER ~ f) SIGNATURE ~ . '\"u..A_OCL~ ****************************************************************** ~0"\~ l;..), \\,~) COMPANya(j',-~ y 0 ~,3G& r' I"' STATE CERT OR REGIST ft R (3DcJ 1353 ~ ~ "/':~ /':r2.? COMPANY ~)I)c::.;C)\ ~ \:-\ ~ ~ e7 STATE CERT OR REGIST # C;:::lCOj~? bS- STATE CERT OR REGIST # ****************************************************************** MECHANICAL SIGNATURE/ ~~ .-' ***************************************************************** OTHER COMPANY SIGNATURE STATE CERT OR REGIST # A. NOTI~E OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to "deed restrictions" v.;-lich may be more restrictive than city regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and l~cal regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, 813-780-0020. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign po~tions of the "Coritractor Sections" of this ~pplication for which they will be responsible. If you, as the owner signs as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that may be an indication that he is not properly licensed and is not entitled to permitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien Law _ Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land development. Appli~ation is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regplating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: *Department of Environmental Regulation-Cypress Bayheads, Wetiand Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment *Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses *Army Corps of Engineers-Seawalls, Docks, Navigable Waterways *Department of Health & Rehabilitative Services, Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks *U.S. Environmental Protection Agency-Asbestos abatement I also certify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is understood that a drainage plan addressing a "compensating volume" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to permit issuance. A permit issued shall ,be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction, or violations of any code. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of issuance, or if work authorized by the permit is suspended or abandoned for la period of six months after the time the work is commenced. One 90 day extension of time may be allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to'the Building Official. An approved inspection must be logged during each six month period, or the project will be considered abandoned. 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. JOBS UNDER (~'5~TO HE/ANa POST ~ . -J SIG~A;~~i OWNER OR AGE,-T ~> . SIGNATURE' CONT~CTOR STATE OF FLORIDA r^ 5 cO COUNTY OF . ~. The foregoing instrument was acknowledged/ Before me this ~ day of O~Cj[M/3t.1t, 2QQ5. by ~&~ c-~~~~~~ ~ (name of person acknowledged) ~o is personally known to me, or STATE OF FLdRIDA ~~ c.:jO COUNTY OF The foregoing instrument w'A-lc~oWledged_ Befo~~ th~1~y of ~ ' 20~ ~y ,\ ~') , ~-r - (name of person acknowledged) . 's personally known to me, or of identification) take an oath. Name 5d-99 'Dream Homes of Pasco 37311 Picketts Mill SQ. FEET PRICE MAIN OR LIVING: 3,328 $ 50.00. OTHER AREA UNDER ROOF: $ 50.00 OTHER: $ - VALUATION $ 166,400.00 FEE SHEET $ 681.00 ADDRESS $ 30.00 DRIVEWAY $ 30.00 BUILDING: $ 1,081.50 CREDIT: $ - BUILDING LESS CREDIT: $ 1,081.50 ELECTRICAL: $ 130.35 PLUMBING: $ 110.00 MECHANICAL: $ 95.35 SUB-TOTAL $ 1,417.20 RADON: $ 33.28 TOTAL $ 1,450.48 .f-~2\~.'6"3 SEWER: $ 1,616.00 WATER: $ 419.00 IRRIGATION: $ - TOTAL: $ 2,035.00 I WATER METER:I $ 180~00 I IRRIGATION METER $ I SUB-TOTAL $ 3,665.48 I ~ . ~ PARK IMPACT FEESI $ 769.561 . PUBLIC SAFETY IMPACT FEES POLICE $ 254.00 FIRE $ 273.00 5% $ 26.35 TOTAL: $ 553.35 J;f SIF'S: $ 4,314.00 100.0% $ 4,314.00 1.0% $ 43.14 TOTAL: $ 4,357.14 TI F 'S 'I S 99% $ 1% $ /~J t~t?--C 9,345.53 , TOTAL: $ 'City ;of ,Zephy~hills Building Department 5335 8th Street Zephyrhills, Florida 33542 813-780-0020 Fax Cover. Sheet TO: FROM: DATE: SUBJ: Jeanine 'Morris Karen Jan. 6,2006 Permits Fax: 1~-547Lf- Your permits are ready with the following understanding: 37311 Picketts 'MiII- Permit 5299 Subcontractor Nuccio-requires his City License to be renewed. $20.00 Copy of proposal and/or contract w/price . Noth~e of Commencement required Permit Fee - $4218.83 - permit plus Safety Impact Fees 5126.70- remaining balance owed -Park Impact - 769.56 -Schoollmpact-4357.14 This remaining balance will be owed prior to C.O. Unless you want to pay for it at time of permitting. Total cost with all impacts - 9345.53. See Fee Sheet. .6444 Laurelwood Drive - Permit 5300 Notice of Commencement required. Permit Fee - $3849.20 - permit includes Safety Impact Fees 5126.70 - remaining balance owed -Park Impact - 769.56 -Schoollmpact-4357.14 This remaining balance will be owed prior to C.O. Unless you want to pay for it at time of permitting. Total cost with all impacts - 8975.90. See Fee Sheet. Total Permit Fee Total Cost w/all imoacts -$ 8,068.03 (permits 5299/5300) J\.Q.,yy...~<=) t2:.o.io..nce ouJe d. -$18,321.43 ( ermits 5299/5300) Dream Homes of Pasco 37311 Picketts Mill SQ. FEET PRICE MAIN OR LIVING: 3,328 $ 50.00 OTHER AREA UNDER ROOF: $ 50.00 OTHER: $ - VALUATION $ 166,400.00 FEE SHEET $ 681.00 ADDRESS $ 30.00 DRIVEWAY $ 30.00 BUILDING: $ 1,081.50 CREDIT: $ - BUILDING LESS CREDIT: $ 1,081.50 ELECTRICAL: $ 130.35 PLUMBING: $ 110.00 MECHANICAL: $ 95.35 SUB-TOTAL $ 1,417.20 RADON: $ 33.28 TOTAL $ 1,450.48 SEWER: $ 1,616.00 WATER: $ 419.00 IRRIGATION: $ - TOTAL: $ 2,035.00 J WATER METER:I $ 180~00 I IRRIGATION METER $ I SUB-TOTAL $ 3,665.48 I I PARK IMPACT FEESI $ 769.56 ~ . PUBLIC SAFETY IMPACT FEES POLICE $ 254.00 FIRE $ 273.00 5% $ 26.35 TOTAL: $ 553.35 I-- SIF'S: $ 4,314.00 100.0% $ 4,314.00 1.0% $ 43.14 TOTAL: $ 4,357.14 TI F 'S 'I $ 99% $ 1% $ : I TOTAL: $ 9,345.53 , December 20, 2005 Mr. William Burgess Building Department Zephyrhills City Hall Zephyrhills, Fl. 33542 Dear Mr. Burgess; This letter is to authorize Ms. Jeanine Morris to act in my behalf in all matters concerning building permits pulled in my name and licensing. Sincerely, ~ :a~' Robert C. Burnette President Dream Homes Of Pasco, Inc. ,~, \:~~ ; o,f'o.' Notary Public Stale of Florida Jeanine M Morris My Commission 00<<5508 Expires 0612812OO9 9l~ )1(, YfJi / ! v _w___ ---------~______ ---------..----r-""'- r { E:3 (- (-, Ii r \ (- (~i ~ OWNER/ RENTER i i -I I I i i I I I i ! i I I G.o."j~{+ :St2-C~ !D(e~ ~ g,t::' ~;II ) . a~ u::p , ~~r~) R.- I Pll!..~ ~ Qu~ I i i ! PERFORMANCE BUSINESS PRODUCTS. INC. 813-71ll-8OO8 FAX 813-718-79111 5- 01 t~ CITY OF ZEPHYRHllLS ZEPHYRHILLS, FLORIDA WATER ACCT. NO. DATE MAILING 3(3 \ \ SERVICE ADDRESS :~ '"""S I \ PI C!..\<e +f~ r'ni , \ SHUT OFF SERVICE 0 TURN ON SERVICE if INSTALL METER B"'" --:Pee 0\:: t- READ METER 0 5 c~Pl'1 CHECK METER 0 OTHER 0 QJ.Je... 13'" WATER o SEWER o GARBAGE g/ IN CITY o OUT CITY -L No. OF UNITS _ DEPOSIT AMOUNT - AMOUNT LAST BILL 3/y (I W~ ~ _ DATE _ MISC. CHARGE WORK COMPLETED BY & DATE COMPLETED ORDER TAKEN BY... '. Retain white form in office at atl times. / Send pink & yellow forms to Water Servife pI. Water Service Dept. to sign yellow form f' n turn to office. I ;, '. :', r; . r,.. V::'I;,,! V. [!J'J() ./, ..., .-....... tr M JI~ .;@; fIR J;i I ~~. (tj l V) Tax Folio No. p ;SO C~ Cl.EllI( fi~02'~':.1. 1 0'12..88 _. OR BK 667 . Pw L, JV j :1: ;'\J, JLjt) ~ L NOTICEOFCOMM5NCEMENT IIIW) 11m U1~lIIlIlml ~II ~~lImlmll fimllUII~ ~~23~Ii6~ . _ RGpt.:938I1:i R.o: 18.50 DS.0.00 IT: 0.00 lli02/05 __ opt.y Cl..rk Permit No......... Slate of FlOl1da County of PASCO THE UNDERSIGNED hereby gives notICe that Improvement will be mada to certain real property, and In accotl:lence with Chapter 713, Florida statues, the following InformatiOn Is prcykIed in this Notlce of Commencement. _ 1. Description of Properly (Legal Description): . SEE! AT'r)lCHED LEGAL - Street Address PICKETT'S MILL AVEHU~. ZEPHYRHILLS, FL 33542 2. General descr1ptJon of Improvement: Single Familv 3. Owner InfolTll8tlon a. Name and Add,ress: JFl~! CAT,VER'r anti J'O'LII!: R CALVERT b. Interest In property~ Fee ~ e o. Name and address of fee 81m~ tltlehotder (if other than owner?: Same alJ owner above -= 4. Contractor (name and address); DESIGN CUSTad HOHES , . 5. Surety: a. Name and Address: b. Amount of Bond: :~ e. Lender; R~G Crown B4nk 105 Live Oaks Ga~dena, Casselberry, FL 32707 7. Persona Within the State of Florlda desIgnated by Owner upon Whom n0tk:e8 or other documents may be servlld as provided by Seellon 713.13(1)(8.)7 Florida statues (name and address): 8. In addition to himself, Owner designates RaG Crown Bank. 10~ live Oaks G1arc1&11s, CllS88lbeny FL mQL to r&celve a copy of the Lienor's Notice as provided In Section 713. f3(1)(b), Florida statutes. 9. expiration date of notice of commencement (the expiration date Is 1 year from the date of recordIng unless 8. different date Is Specified); _ ~~~ ~~~ C~~UJk~ Sworn to and SUbScrltiid before me, an officer duly alrtttorlzed In the ~L~nd County aforesaid to admInister oaths and take acknowledgement, tflls..:.JLdaY of 0 A. ...:lO.<(\ !("' . Signature of Owner My commlsslon expires: ALoL~d~ ~ 8uAn I>.. Morrow NDtaJy PubIlc, s. of FIot'/(JlI MyComrnlsslon ExpIh18. Feb. 10,2008 Com. No. OD282875 Notary Public DOC ..55~078 APPL *'0206008899 CB015 '.!Gl, 1'1, LI/U;J L,J\J 1~1 ,1.1, J L J \.I r , ] ~ . - ... Exhibit "A" OR BK 6673 PG 1289 2 cf 2 The Weat 12 fcot of Lot lSB; Lot 15C and the But 11 leet olLot ISD. SILVER OAKS VILLAGE PHASE ONE. as per plat thereof recorded in Plat Book 35, Page 63 thru 67. Public Records of Pasco County, Florida. ..... ,... BUILDERS PERCENTAGE AND CONSTRUCTION RETAINAGE MEMO TO: R-G Crown Bank FROM: DESIGN CUSTOM HOMES DATE: October 31, 2005 RE: JEREMY R CALVERT & JULIE R CALVERT Please be advised that I am receiving 10% of the Contract Price, less the Lot at closing and I realize that the First Disbursement will be less by this amount. Contract Price $ 289,750.00 Less Lot Cost of $ 30.000.00 = -$ 30,000.00 X 10% $ 25,975.00 -$ 25,975.00 Less Closing Cost paid by Builder -$ 0.00 Less Real Estate Fee paid by Builder -$ 0.00 Total LIP Retainage $ 233,775.00 The initial 10% will not be disbursed to the Builder by the Title Company until recorded Notice of Commencement has been received. If monies are disbursed to Builder prior to recording of Notice of Commencement, the Title Company will accept full liability. Funds to be disbursed from any proceeds forwarded to the title company or collected at closing from the customer less any deposits verified received from the builder. Checks are to be disbursed to the Customer unless instructed otherwise by R-G Crown Bank. ~ _ N C HO S ~~ t Builder: C B055 A. u. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT Sunstate Title Agency, Inc. 13937 7th Street Dade City, Florida 33525 352-567-1141 fax: 352-567-3830 B. TYPE OF LOAN L lJFHA 2. 0 FMHA 3 GJ CONY. ITNINS. 5. [J CONY, INS. 6. File NWlltJ.,!' 7. loan Number: _ ... t:;'~'~:C"'N~:---~ c. NOTE: ThisJorm isfurnished to give you a statement a/actual settlement costs. Amounts paid 10 and by the settlement agent are shown. items marked (pac) were paid outside the _closfng.~ 7}~e~ ar~_shown here lor informational purp~sesand ar~ _floLt!!f:-'/ud'!JJ, i~IJhe totuls. D. Bon:.ower: JEREMY R. CALVERT i1ndJULIE R.CAL VERT. hls wife____.. E. Seller: SOUTHERN DESIGN CU~TOM H()MES, INC. /DicAj.fHDMf:5 Or fl~.'L<:"(). IJJC. RG CROWN BANK F. Lender: Picketts Mill Ave Zephyrhills, Pasco County, Florida 33542 W 12 feet of Lot 15B; Lot 15C & E II feet Lot D, SILVER OAKS VILLAGE PHASE ONE, Book 35, Page 63- 67, Pasco County, FL Sunstate Title Agency, lnc. 139377th Street, Dade City, Florida 33525 Pasco County October 31,2005 - G. Property: H. Settlement Agent: Plaee of Settlement: L Settlement Date: J. Summary of Borrower's Transaction K. Summary of Seller's Transaction 400: Gross Amolll1t Due To Seller; 140 I. ContractSale~Prjce 402. Personal Property 2~r~~~:r~~- 29,029.02 405. Ad"ustmentsforU~JlisPaiiLll}' S~n~!il1 4~Mce: _. 406. City /]o~E_T""e~, 407. County / Parish Taxes 408. Assessments ------~-~.._~,~-_._-- ~---~- 409. 410. -.~~-,. 298,217.72 420. Gross Amoull_t1!u." to Seller: 100. Gross Amount Due From Borrow.er: 101. Contract Sales Price ~~u. 162~rsonarProlierty u__ . 103. Settlement Charges to Borrower (line 1400) 104. LIP Retainage Account 105. Lot Purchase __,~.ct,j,ustments for Items Paid b Seller in Advance: 106. City / Town Taxes 107. County / Parish Taxes 108. Assessments ~.._,----- lID. 120. Gross Amount Due from Borrower: 0.00 -------------- -----..- .-- ------,._- ---~- 200. Amounts Paid by or in Behalf ofBorr()wer:__ SOO.Reductiol!!; in Amount Dlle to Beller: 20 I. De osit / Earnest Monesoo.oo' 501.- Exc~s~JS;-osii-see inslruct-io~s--- ~Q~---l'rlncipal Amount of New Loan 275,262.00 502. Settlement Charges to Seller (1jn~)4Q.Q) ____ 203. Existin Loan s) . --563: Existin LoanCS-u- -.- -, ~___. 504. Payoff of First Mortgage to ;~~: ,~__~~=----- .. -=--l~~~~~~~:~~:~e:~:yd;::~a~geei~~ Ad.ustments for Items U aid b Seller: . Ad'ustmeiits for It~i!IsllL'!flaiil bySlilllir: 210. City/TownTaxes '_____.__________ 510. City/Town Taxes ___~~__ ~}~~unty / Parish Taxes 511. County / Parish Taxes _____.. 212. Assessments 512. . Assessments -_.~.._---_._---~------- 213. 513. 214. 514. ----~--_._- 220. Totlll Paid by I for Borrower: 275,762.00 520. Total Reductions in Amount Due Seller: 500.00 10-,390.00 10,890.00 300. Cash at Settlement from / to Borrower: 301. Gross Amount due from Borrower (line 120) 302. Less Amount Paid by/for Borrower (line 220) i MO.. Casllat SettlemerittoTfro;;:'Sell~;::___ 298,217fi 60i. Gross Amount due to Seller (line 420) 0.00 6~ 00 602 Less Reductions Amo-u;;t-du~ Seller (line 275,7 L.. . 520 10,890.00 -_.'-"---~-- 303. Cash From Borrower: $22,455.72 603. Cash From Seller: $10,890.00 HUD-l March 2005 October 29. 20054:15 PM OMB No. 2502-0265 RESP A handbook 4305.2 Settlement Dato:Octobcr 31,2005 File Number: S-25083 A. U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT Sunstate Title Agency, Inc. 13937 7th Street Dade City, Florin" "<;':>'; 352-567-1141 fax: 352-567-3~3U ~ 1), Borrower .;X Ill,!, feu ~ ~F~a1LVERT Horrower: ~l.. () r\~)n) Ct; \) J. lOr( J LIE R. LVERT "- The HUD.I Settlement Statement which I have prepared is II true and accurate account of this transa~lion. acconhmce with this statement. 1 bave carefully reviewed the HUD-l Settlement Statement and to lh~ best afmy knowledge and belief, it is a tnIe and C1ccuralc statement of all :~eceipts and disbursements made on my aL:count or by me in this transaction. I further certify that I have received a copy of HUD-I Sdtkrnem Statement CSl'"n.J THERN DE....S.I~. . c....~. "~9 Seller -;f --'~.~ ~ _ y- I have caused or \vill cause the funds to be disbursed in Settlement Agent: ~/>~/J1A"'~-JAy...~ Date: October.11, 2005 SUNSTAIE TITLE -~ . -~- --- file No.: S-25083 WARNING: It is a crime to knowingly make false statements tu the United States on this or any other similar furm. Penalties upon conviction can include a fine or imprisonment. for details see: Title 18 U.S. Code Section 1001 and Sectiun 1010. HUD-I March 2005 October 29, 20054:15 PM OMB No. 2502-0265 RESPA handbook 4305.2 ! (.J !" j_ .~ ~: ; .. I II ,. ' ' ; I': { ~ - : ;:; , -f~ . -'r'"q " J' it,if.' ('.; ,.. j.... '" q i.'d V,\"~( .[ ( t.-;} i.J!:, hi:-', ':.q. . ) i.<:",'\ ; 'j i.,1 j I' II PFl\ITI::'^' 1"'::; :{ .. ,',i j ,::'I::.'::tM T .YO'V" .,. ~.h.~' L.11 J."'\'.)' ill -1-,_,~ y.......,.....,... . ,(1-/ ;.11- . -,';' '" ~.t I.... i) i- >" '1-, ~ 'I d ,.,i -.n'- .:( i'. -I: \\(';j I! f'.l 1:: I, i,