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<br /> 2016056431
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<br /> 1�7��T[t__i!• Oi+ �'.O?.V.[I1'1LI'�TCl:I�/ri;`d"1' Rcpt:1762858 Rec: 10.00 �
<br /> ' '� � — DS: 0.00 IT: 0.00
<br /> • � 04/13/2016 L. K. , Dpty Clerk
<br /> Permit t:o. • - - — ---- --- — —
<br /> Tax Folio I�io.__.���=z1- G1\S!0– t�JJJ•) �Z1J
<br /> THF U1VL�ER_�IGi�D herehy gives notic�tl;at irn�.ru�r•emcnts will'oc mad�.tu certain real property,and in accordance with Section
<br /> 7.3.13 ot'thc rlorida Siatuies,LI1C fO1101Y1P�';niormatien:s pro�,�i;lcd in this NO'TICL UI+COIVIM�l�'C�MI.NT.
<br /> 1.Descri tiun of ro er [e=rcl descri tio�i :__ S - �l - d��� - ������
<br /> P P P h'( S P ) � �I- � - �'j 22�7
<br /> a)Street(job)Address: 3763`I ��rew L��,,,T��vt _Ze�,�,�r������ F=� S`� _ ���
<br /> 2.General descriptiou of impravements:
<br /> � .�,r��� �1\ J�c..l �M�n�{`�,c' _v r Z���v.c �in ���1 � �v. ('Trv (���f i i�n S
<br /> ' 3.Owner Information � . —
<br /> a)Narne arid address: �tir�i�r� �, w��1•",�.c .��� C��.1�2t`/ ��cS/��/, �{y/��l�S �Z
<br /> b)Name and address of fee simple titleholde;(ii'other?nan owner)__� ---�$�77YP
<br /> c)Intcrest i�i pi•operty ____ O�,vn<< '}1.r,,vh�. ��v� — ----- ,
<br /> 4.Contractor Informa�ion - -- —
<br /> a)N�imeandaddress: �`�� � P��` '�J�S� fvcfl,,, S�rv�crc .�rc � �� ��X �7� i,,��n',,r t,wc„ f=-L ��k2
<br /> b)'Celephone I�ro.: �_t6(�3= �16�-c�7�,� ---------F�;No. (Opt.)�- �y� �
<br /> �`--------�----
<br /> 5.Surety lnformation ,
<br /> a)Name and address: N 1�
<br /> b)Amount o±';iond: ��� � � --- ---------
<br /> -4-------- - ---•
<br /> c)1'cle;:hone No.: r1 1!�= _ _I'ax No.(Gpt.j ,U �---- -- --
<br /> 6.Lcndcr --_------- ----- .
<br /> a)Namc and address: 1V� /�
<br /> — N�-- -•--- Phone Na. ��----- -
<br /> 7.Identity of persc,n w�ihin the 5'tate of rloriaa.dcsignatcd by owner upon whom noiices or other documents ma,y be scrved. �
<br /> a}7�';Lne�td address: � � I
<br /> b)Tclephonc I�o.: .,:ax No. (Opt.) --- '
<br /> B.Ir.addi.tion to himsclf,otivner designatcs the followinr;person to rcceivc a copy of thc Lie�tor's Tdotice as provided in Scction
<br /> 713.13(1)(U),F!orida Statates: ,
<br /> a)Narneandadd:ess: Mc.e'lc S`�t���� � 1�1�� �� N��r�sk. �rc I�w��,� I^� 33G�1
<br /> b)Telephone No.:_�__�13 �?7-7�,,�� Fax No. (Opt.)��, q77-sy�s,s .
<br /> 9.F.x,�iration date ofNotice of Corrii;.:,;�.cernent(tlie cxpiration datc is onc ycar firom thc date of recordiu;unless a diffcrent datc
<br /> is sp�cificd): i
<br /> WARnTINC TO nR'1�'�R: AN1'PAYiVI�N`1 S MAll�BY TIIL OWNER Al�['l;It THE�XPIl'.a.7'IO!\ OF'1'II�:l'O'1•icL or� �
<br /> f� COM�11��`C:I;IY,CLNT AR� CONSIDLR�D TMPROP�R PAI'117L�'1 S UNDLR CI-IAPT�R 713,Pr1R1'].;S�C 1'IOi�'713.13,
<br /> 1�LORIDA S'!'�i7'U1'LS,.Al!'ll CAN RI',SULT IN XOUR PAYING'1'�VICI' FOR T,vIl'ROV�,l�1E\'T�'I'U 1'OL'R PROP�P�TY.
<br /> A 1\'OT.CC:1�or• conrn-c��'C;L•'�1:ii,1�'T P,�U51'L'T:;P,1�COrliT�:l)�1ivl�PO�TLI� Q�;TIl�JOIi SITr IiLI?OR�TIIL I'1RS'f
<br /> TF+`�;YL(::i'ICi�. 1I�'YOii fN11';I\'.l'� 1'C C)1.�'.l':!I;V l�I��AR'(:?id%, C171'iIl.T_•"i'].'U-Uf? I,i;i�°r,?�_I? qi� ��?�: :aT'(lI:';�''�_1��:l,i:(liiT: 1
<br /> C�V�vicllLiV�..ir�., �'t•''il;.[Ci.)l:-�._I+.(_'U1�{)�!`;�, �� 1 ^" ll -`I� "t � "— i, , _ ,' _ . ._
<br /> _ i c;i:_C� ,� ,_. . C.:r G;riil�i�� , ��.
<br /> ,`:Cis 1L:4 .
<br /> �/ STA'fL'OrCLOR1LA ` �
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<br /> 1�. /�, �,_- � i
<br /> . �'��N/ j
<br /> � Signature of Owner or Owncr uthorizcd OFticer/Uirector/Partned:�:�iager I
<br /> �bf�xr� _J. W ��� ��vrC I
<br /> � Pnnt Namc --
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<br /> i 1 ne fore�,;oing instr,ument wa;acicno��ledged hefr�re me this �,1;_ day of �'1�.�c. h �20`� b�;� , �
<br /> n ` � ---
<br /> � _1"°'1!'�c��, S_ �e.',� — a; fV;i�`'r`7 " (type of authority,'r..g,offtcer,irustec,
<br /> attorney in fact) for f�e.f Jh�-. � , w����w^4 _(tlamc of party oii..bqhalf of�vhom in ru t�vas exccutcd). I
<br /> � �' � �
<br /> -� Pcrsonally ICiiown OIZ Produced Identification� Notary Signature � � �LL•GGc-G,�
<br /> TypeofIdentificatioriProduced W�ISZ-�7��`1� -�'��� Name(print) Q '� � � � �e�.J ,
<br /> 0. (`\C�� �
<br /> Df�Vl� �\C'CnSC �R —
<br /> Verification pui•suaiit to Section 92.525,rlorida Statutes. Under penalties of perjury,I declai•e that I have read th�fore�oing and that
<br /> the.facts stated in it are true to the best of my knowledge and belief. .
<br /> r•oxn�smoc,ry,�oio , � �',��� /, ] .
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<br /> Signaturc otNatural Person Si n g(in linc{I 10.)Aborc -
<br /> ,��������� PpULA S 0'NEIL,Ph D PqSCO CLERK & COf1PTROLLEf�
<br /> •�nYev,�., PATRICIAS.REW 04/13/2016 10:llam 1 of 1
<br /> � ;�' ;;__ Commisslon#FF 145307 OR BK n G
<br /> - :'�•���: Expires September 5,2018 .7��J� P� 2445 I
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<br /> � �fj�,�t'"` B�d�d Thm iroy Fdn Ineurenoe 800385•7019 ' --` ---- �-- --—— -- —
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<br /> S�Al"E Os �LOFI�k', CCfU�T`(�� PA aC0 ,�� ° e ��°�
<br /> THIS ISTO CER I IFY THAT TfiE FOREGOI�IG IS A �
<br /> o �
<br /> TRUE P,IVD CORR�.CT COPY OF TNE DOCUMENT � '
<br /> ON FILE OR OF PUBLIC RECORD IN THIS OFFICE • • ' �. �
<br /> WITNES,S MY FiA�IU AND OFFICIAL SEAL i HIS/ � ' IrtiGod"We�"rusr � '
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<br /> �_QAY 2 �G f� � � �,� . � �
<br /> PAULA S. O'N�IL, ERK&COiVIPTROLLER �
<br /> /� � . IS&7
<br /> BY �dll=��i---B�-�LLTY CLERK Es�'��������1,��
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