HomeMy WebLinkAbout12-13749 CITY OF ZEPHYRHILLS
. 5335-8TH STREET
(813)780-0020 1 49
FENCE PERMIT
Permit Number: 13749 Address: 4802 PLUM ST
Permit Type: FENCE ZEPHYRHILLS, FL.
Class of Work: FENCE/NEW Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: MOORES FIRST ADDITION
Est. Value: Parcel Number: 1426-21-0010-03500-0110
Improv. Cost: 3,000.00
Date Issued: 1/03/2013 Name: REINERT WILLIAM JR & MONICA
Total Fees: 60.00 Address: 37689 300TH AVE
Amount Paid: 60.00 DENT MN 56528
Date Paid: 1/03/2013 Phone: 218-535-1222
Work Desc: INSTALLATION 349 X 6' WOODEN FENCE
HOMEOWNER FENCE 60.00
/ "��, _
�.
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80(2)(c)when extra inspection
trips are necessary due to any one of the following reasons: a)wrong address b)condemned work resulting
from faulty wnstruction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site fl plans not at job site g) work not accessible.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions appiicable 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
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
� �
ONTRAC OR PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
� ssurw ry BLOCK 35
Y i � �
----- ----- I N90'00'00'E{P) 132.00'(P) I
��� � N89'S8'49'E(M) 132.09'(M) I ��� �
� � Fv+cc�s.a a � a��.r a
� a'aF�.. �ro�a o.r a�
�: «r
�' °�� �LOT 15 �
�� BLOCK 35 x
D�. .� �I
�
--- • tlx O
�
x --�----1 z
��� ',I 8 OCK35 �_
Z � . �}%• x � y
arJ'
O � ` '.�,I IEiK �
N ' !m x t1N
.'
N r__ � .'�.. arW
N '., .r^ l�i V
_ 4_. � n voo� rrj
� � x•—' �x � �
� ..1�� �J� �
~ t, ,- '{' B OCK 35 ( � �'� �
a :— & �j�i` �'� �
Z ,/ �- �?�T "°3rRPJ— ———— �
3 � TT1L� N�C �r07
Z � '1" 1
Y `� ` � l�-!�tv��� LOCK 35 f�L�.G'����:��. �,i ii!.! � \jj'i`; '��11 i�l �I.l_
�-. N �4��',11Llti�t,('t!�}I `� i-i �=�i�1 ):`�I�UILI)1�`:G
� � �'�)DE,',`��'.i(_)\'�I.! I ?(�i:' CODE ;���D
� �.__� /s/�� l�lf
; -- ,�.s,— —�— -li`'(�1� 1I=;,la�•n�{11 ; � ,;R �'�:�'�'('L-`
1 �
LOT 11
BLOCK 35
---- — �— ---- ��
LOT10 t'�� �r����1�' (.�r`,`i '�"�� �
BLOCK 35
� �, � '7Y ��{ ?�=� -;�' '!-�;f f �:
� F�
p O f.�•i..�-1�`�.� ��h:�tf� �~' l��
S90'00'00'W(M 132.11'(M) ��F"t,
���� S90'00'00'W(P; 13200'(P) r�ivciq�x
�'�s7
KNOWN AS a+�rwc scuE
( :1�'I.I�[.I: '�
�u.T na�o _.
, , � , , Risr ii-ioo+se
,,,�._ w,,:,�-�. �' , ,,
�� � - �= �owaess� cuerrrr iaz-�
��� ;�' �--�- -- '�` \ FELD OATE: 30/27/11 �
� _. :�LJ`�:l�:i'i_ DRAFTER: S0.S l
-��M - ,;.-.1 �f . ,"� i� .. ��,_\ --
�A7PYMLLT � � , �.��- .�: �APPROVED:B� 1
��-�� ` LEGAL DESCRIPTION:(AS FURN6HED) ..�\ SCALE: 1•.$�'
��� ,-� LOTS 10 THRU 75,BLOCK 35.MOORE'3 FlRST AppfTlpN 7p 7►{E TOWN OF gPHYRH0.LS, � �--�-
% ACCORDING TO THE PLAT TlEI�OF, `,� L----�
��!____ AS RECORDED IN PLAT BO01(7.PAGE(S)57.OF THE PUBLIC RECORDS OF PASCO COUNTY,RORIDA '�_1�_ �
:i___BA41S OF BEARINGS: BEARMIGS SMONM HEREON ARE BASED ON THE SOVTH L1NE OF l0T 10_BLOCK 95.BEMG S 90'OD'00'W.PER PLAT ''�
� _-3URVEVORINFORMATION: _T._-_____._-_ _-- _ _-__--_.-_ ____ -.__
RESIDENTIAI.' .M � —�- �;
` � 3�-
LAND SERVICES "i"�"'� %''�"
,�:......�.�w,w�.E. ��_ ,,,�- SeeAllyNewl�ome!
IM�r�.OK 7i1�0 ' �
FAX:(�00�VSW)09 Firs1 American �
YNONE:(M9)yFSDOp I I
WWW.RtSNOW.COM �TtIIC InSUfBRCC COIDp277)� �
sU R ' �uE.:uTUNFAeaErR�.11SNH4cVILLmE�eBErrtl------- -
TM°'�°'•+°�°"^^++�+ww.++�++�.+s ae:�ptmwrtaree aw:ou�r,outirryurE � SURVEYOR'S CERTIFICATE
'_uir.w��.�ar�wyq�rr�.+r�.W�. tln6:WIL01q ry.kRwTTED -- —_
cERI�I�TO:u�sPWiuED) � i�tu�cuu� v.cra`.roseunv�n� I teew��.wmwme.nar�war+ee�remmeeamenrrn.nawia
�i Gb oqmlFAR�Ki v.OA PdMf oc BEOIII�IG aWrYila YM slMya h Avlh.As�[!vN Y�O�Ob 61G 1
JMES MCINBS MEADOWS 'ClW.00NOlIE M.00t WN1 PAG PdN!OF OOIMIEMQiBR 7�G FbrIN
FR4TIIMFAICAN7IiLENSURANCE00A1PM/V E:�Itea1E PP:PdMVePR[ +�mOe.PUa�RbO�pMO7d2),I�W�r.
PHMMORTfi11OECORPOMTION �•MA:WSERrqTACCE�BLE VAC4POMfdFI1EFEA8E
I W.V�H'L/H1� CIRV�TIRE
LW.CO�ERED PRlL'PEIYMFffRSB1BICE
�DLE:UR�IMIiEtURIfYEA6E1Eiif MOIMIBIf R.
'-- ----__ ._�ow.oq.�evrwr ��� I ��r�'pTlfl���S
__NOTES_—' � �KK�EMIM� at:cwWtlr�tcErNf I �'C+�j��0�'�
os.unNN[iEFABBBIr Wf:YwoonPENCE e �� a
�.u000uaoonle�r�r.uwne�.�.ewaq�o �L�666ZdRE---___ _____ � � � �
�.rdw.msrnwm�aunwnuw fFanNalWlp/MLPWOlE8atv) FOR
�wc�uKRwrbu�nw�aa�cv SUBEC�MIOPERfYS1qWN1EREp1�WFEAR3TO8ElDC�iFDN �J
n..veona...a.ew.�E...a rwmmrExNS,�anmcasnrtimwviaom�a.rcasur + STATEOF DA7ED:1027H7 RM
�m�i wau�xo`nau�m umm� PNIBMIIIER11�60006C.1A4�NEVIBqNMIEt]/t�pt '
� ��y�ypp �sC�amnE�oan�croF�suRVEVORSluME: R N50Be LBN1ese
THEl1lOVEtf.OVl�1�e�iLPMr'MC��lNOUIDBE� <�Np 8U1�`�t
ror:n�i iwou�aics cout.c.�NOT VALD WRHOUT AN ELECTRONIC SIGNATURE
n��seumrevnr�u�swnE�ue�ue¢ SIDEN Ris 'MIDAUTHENTICATIDELECTFiONICSEAL '
uom�srtorn�w�miesuer��+c�an � r----r-- ---- - -- -
rnJ�i�A.�nw<om `DATE , REV�$IpN i pq7E ' REytiqlpP�
�Nwrrron�wov�mES�wvraree SERVIC i.os�3��seoo ----- - j -------
*nn,erermmon�eeor�o. —r 7� ,
— _ _- __ r�—=-� � �
- - -- - --
,.,.�
--- --- -- --�--
--- -
Fteviewed&AcceGted by y,_ _ _ pa�F` � Cate
aJ eJ�� $'tY� ��-
l tb'
813-780-0020 [� rd``t ��iu�
tY ,,a�L, City of Zephyrhills Permit Application ��r C� Fax-813J80-0021
. � �,ar�`�,�c��n Building Department �
r
Date Received
Phone Contact for Permittin
Owner's Name Owner Phone Number �p•- J ~��2v2
OwnersAddress � $Q� ���c,�,yY-� �-�- OwnerPhoneNumber �
Fee Simple Titleholder Name � —� pymer Phone Number �
Fee Simple Titleholder Address
JOB ADDRESS �2..- S `I� LOT# �
SUBDIVISION _ PARCEL ID#�
� (OBTAINED F�PROPERTY TNC NoTicE)DEMOLISH •
WORK PROPOSED NEw CONS7R ADD/ALT SIGN
INSTALL 8 REPAIR CJ � �
PROPOSED USE Q SFR Q COMM Q OTHER L 1•t�1 C 2 ` �v"�p,D
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q
DESCRIPTION OF WORK � �`A ` ,3 � ���� , ,
BUILDING SIZE � SQ FOOTAGE� HEIGHT
OBUILDING �
�j i d�0 • VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
OPLUMBING � � ����Gf
/
OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
OGAS 0 ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
,�UILDER � COMPANY � D m,.Q� �NJ jt,
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �— �
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �—
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �
RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
Minimum ten(10)wo�icing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8�1 dumpster.Site Wark Permit for all new projects.All commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
"'"`PROPERTY SURVEY required for all NEW construcdon.
Directions:
Fill out application completely.
Owner&Contractor sign back of appiication,notarized
If over 52500,a Notice of Commencement is required. (AIC upgrades over:7500)
"' Agent(for the conUactor)or Power of Attomey(for the owner)wouid be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"des�i" rest�ictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
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 local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemyan�op y iolation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements ma a I for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the cont�actor(s) sign
portions of the "contractor Block" of this appNcation for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW(Chapter 713, Florlda Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the appticant is someone
other than the"owner", I certify 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.
CONTRACTOR'SIOWNER'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. Application 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 regulating
const�uction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government 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 Protection-Cypress Bayheads, Wetland 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.
- US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone"V" unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for Iots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, t promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. 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 codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension
may be requested�the e'xt nsion. f work�ce'a es��r'ni ety(0)rconsecutive days,the job is�cons dee d balndonedstrate
justifiable cause fo
W A R N I N G T O O W N ER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR �MR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT._� C O N S ULT
WITH YOUR LEN�ER•
FLORIDA JURAT(F.S. �17.03}
� ' -- CONTRACTOR
OWNER OR AGENT Subscribed and swom to(or afflrmed)before me this
Subscribed and swom to or a a e e r�e this by
bY � Who islare personally known to me or haslhave produced
Who islare personally known to ma ora n���e nroduced as identlfication.
Notary Public
Notary Public
Commisslon No.
Commisslon No.
Name of Notary typed,printed or stamped
Name of Notary typed,printed or stamped
Pasco County Parcel: 14-26-21-0010-03500-0110 001 Page 1 of 2
�ata Current as of: Weekly Archive - Saturday, December 29, 2012
Parcel ID 14-26-21-0010-03500-0110 (Card: 001 of 001)
Classification 01 - Single Family
Mailing Address Property Value
REINERT WILLIAM JR&MONICA Ag Land $�
37689 300TH AVE Land
DENT MN 56528-9235 $36,433
Physical Address Building $29�6�9
4802 PLUM ST Extra Features $8,494
ZEPHYRHILLS FL 33542-5729 7ust Value
¢74,606
Assessed (Save Our Homes) $74,606
Leqal Description (First 4 Lines) Homestead 196.031 - $25,000
MOORE'S FIRST ADDITION TO TOWN Non-School Additional Homestead Exemption - $24,606
OF ZEPHYRHILLS PB 1 PG 57 LOTS Non-School Taxable Value
10 THRU 15 INCLUSIVE BLOCK 35 �25,000
School Distrid Taxable Value $49,606
OR 8710 PG 1068 Warning: A significant taxable value increase maq occur when sold.
Click here for details and info. regarding the posting of exemptions.
Land Detail (Card: 001 of 001)
Line Use Description Zoning Units Type Price Condition Value
�� 0100 SFR OOR3 19,800.00 SF $1.55 1.00 3
2 ���� $ 0,690
� 0100 SFR OOR3 18,526.20 SF $0.31 1.00 $5,743
Additional Land information
Acres 0.88 Tax Area 30ZH FEMA Code C�Residential Code ZHLGLP7
Buildina Information - Use 01 - Single Family Residential (Card: 001 of 001)
Year Built 1961 Stories 1.0
Exterior Wall 1 Aluminum Siding Exterior Wall 2 Concrete or Cinder Block
Roof Structure Gable or Hip Roof Cover Built-Up Tar and Gravel
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 Carpet Flooring 2 None
Fuel Electric Heat
Forced Air- Ducted
A/C Central Baths 1.5
Line Description Sq. Feet Repl.Cost New
1 BAS 1,080 $43,362
2 FCP 190
3 UST $1,927
— 260 $4,176
Extra Features (Card: 001 of 001)
Line Description Year Units Value
1 CLFENCE 1973 1,360
$479
2 UDU-M 1979 1 $245
3 POOL-6 1973 396 $4,752
4 SCRN-FF 1979 1,760 $1,531
5 �� COOL DK 1979 350 $652
6 D W C 1999 484 $835
Sales History
Previous Owner MEADOWS JAMES MICHAEL
Month/Year Book/Paye Type DOR Condition Amount
Code
06/2012 8710 / 1068 Wp�t� 0�� Improved $92,000
r—�
http://appraiser.pascogov.com/search/parcel.aspx?sec=14&twn=26&rng=21&sbb=0010&bl... 1/3/2013
S/H
� • Illllilllllllllllillllillllllllllllllllllllllllllllllillllll
2013001553
Repl:1486574 Rec: 10.00
D5: 0.00 IT: 0 00
01/03/13 E Munguia, Dpty Clerk
PpULq 5 0'NE1L,Ph D PRSCO CLERK & COMPTROLLE.
030R BK3 8807 1PG�2985
NOTICE OF COMMENCEMENT
Permit No.
Property Idcntifica[ion No._ I 7'- �F7 � � I -O U I� • U j =� (�U �U l��
THE LINDERSIGNED hereby gives notice that improvements will be made to certain rcal property,and in accordance with Section
�13 13 of the Florida Statutcs,the following information is provided in the NOTICE OF COMMENCEMENT
1 Description of property( al descr tion:)
a) StreetAddress: �o�. ��1 wrn 6, �� � � �_ � � ��,�, �
I 2. General description of im rovements �
vt2Ooia�.� �PYI��`.P 1�� X
3. OwnerInfortnahon •)
a) Name and address: j C:�.YY1 Q � `�'g�1 ��( % ' � h� � , _Q
b) Name and address of fee simple titleholder(if other than owner) � �S �
� c) Interest in property
4 Contractor Information ' ^ !� 'I
b) Name and address: W t���l�.TYI f� n f� 7g��. P��n'l 5�.�.o p_ �u�}�,1�(� `J"J3��a--
) Telephone No. �� ,�3� I � �. Fax No.(Opt.)_ �T���
5 Surety Infortnation
a) Name and address:
b) Amount of Bond:
c) Telephone No.
Fax No.(Opt.)
6. Lender
a) Name and address:
7 Identity of person within the State of Florida designated by owner upon whorn notices or other documents may be served;
a) Name and address:
b) Telephone No. Fax No.(Opt.)_
8. In addition to himself,owner designates the following person to receive a copy of thc Lienor's Notice as provided in Section
713.13(I)(b),Florida Statutes:
a) Name and address:
I b) Telephone No. ^� Fax No.(Opt.)
9 Expiration date of NoUce of Commencement(the expiration date is one year from thc date of recording unless a different date is
specified):
WARNING TO OWNER:ANY PpyMENTS MADE BY THE OWNER AFTER TIIE EXPIRATION OF TFIE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13,
FLORIDA STATUTES AND CAN RESULT IN YOUR PAY[NG TWICE FOR IPROVEMENTS TO YOUR PROPERTY.A
NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION.IF YOU IlVTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOU NOTICE OF COMMENCEMENT.
STATE OF FLORIDA �
COI.'VTY OF PASCO
SignaNre wner or C�mer s Authorized O�cerlDircctor/PeMer/Managcr
�;nt—�u��J_l.�m�n�r�
�
The f�re&oing instrument was ecknowlodged before me this�day of �Ct nu�., ,20 13 b
�i)i (fil�cl+'1 QP� n2iT � — � Y
f,,��,��� ( of authority,e.g.officer,trustee,attomey in fact)for
(name of party on behalf of w in'nstr�ment was executed),
Personally Known_OR Produced Identification_ Notary Signature
TypeofldentificationProduced��C�V'�( �,�(prl.�,� Name(print) , QpIry1NESI0t1#EE04D5
Verification pursuant to Sec[ion 92.525,Florida Statu[es.Under penalties of perju [d I� th
�,, r aoa�es�o�o
in it are true to the best of my knowledge and belief, t the facts stated
/OItMS.^Ip�md3001
Si�aUCe o(Nalunl R�sun&�iny Abovc
STATE OF FLORIDA, CQUNTY OF PASGU
TH1S(S TG CEF2TIFY THAT THE FOREG4IUG IS A 3U�� �IQ
TRUE AND CORRECT COPY OF THE DQCUMENT ,�`Y" ' CG
O N F I L E O R O F P U B L I C R E C ORD IN THIS OFFICE �' ,��►
WITNE$�6 MY HAND AND OFFICIAL SEAL THIS % ' .
�l�I� DAY OF��:�(-�/ 2 �/ • �
* � Jn yoQlve 7ru,• �
PAULA S O'NEIL, RK& C�MPTROLLER
l °~ *
$Y � \�kJ
D PUTY CLERK * • � ,� •*
�c ttfb7
�'A�oF�.�'d'°� - -