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<br />This space for use by Clerk of the Circuit Court only. <br /> <br />" <br />". <br /> <br />1\11\\1\11\\11\\1111\\1\1\1\\1\1\11\11111\ \11\\1111\ \\1\\11\ <br />2004222771 <br />Rcpl:835054 Rec: 10.00 <br />os: 0.00 IT: 0.00 <br />12/01/04 --- Dpty Clerk I <br />JEO PITTMAN, PASCO COUNTY CLERK <br />12/01/04 01:28~ 1 if3~ <br />OR BK 613~ PG ~ <br /> <br />STATE OF FLORIDA <br />COUNTY OF PASCO <br />THIS IS TO CERTIFY THAT THE FOREGOING IS A <br />tRUE AND CORRECT copy OF THE DOCUMENT ON FILE <br />OR PUBLIC RECORD IN THI~ OFFICE. fJlJNESS MY <br />H D AND OFFICI r SEAL THIS ~ DAY OF <br />2 ,~~ . <br />JED PITT N L K OF CIRCUIT COURT <br />DEPUTY CLERK <br />BY <br /> <br /> <br />NOrla~ OF CQMM~tlC~M~N! <br /> <br />State of Florida <br /> <br />The undersigned hereby gives no lice that Improvements will be made to certain real property, and in accorda.nce with <br />Section 713.13 of the Florida Statutes, the following Intormatlon Is provided In the NOTICE OF COMMENCEMENT, <br /> <br />,. Legal Descrlpllon of property (street eddress required): '3 '7 .4- 0 t> 01 L- L 4. vEL 0 T /6 l.( <br />. 1" - 25 - 2-/ - !JOt 0 - oz<f'OO - 0 I~ '-/ <br /> <br />2. General description of Improvements: A L- v 1M. ( /.../1/ IV\. .p A clcA & E' <br /> <br />3a. Owner Name: GIlA /J(J /-ttfl{ll -ZojJ ~1Il1-+ P . <br />Owner Address: ?t,t.{!;; C;ZfE/J 5"Lofe {JIL. zFPH Vla-f' Ll5 Pc. 'bJsc.f( - .r;~rs 0 <br /> <br />3b. Owner's interest In site: <br /> <br /> <br />3c. Fee Simple Tille holder (of other than owner) <br />Address: <br /> <br />ContraclorName: 13'7.-H Co,vf7!lJL.Tfo/J of-- CE/V/f2A-<..- <br />Address: 'If) 1. ~ f11.otlfll5 fJ,[lI06F PI}. zFtltiveH/uf' /::'(" 3JSL( J <br />, <br /> <br />t::- L . <br />Phone: J--/J-7ff'Z-- /bb Y <br /> <br />5. Surety Name: <br />Address: <br /> <br />Amount of bond: <br /> <br />Phone: <br /> <br />6. Lender Name: <br />Address: <br /> <br />Contacl: <br /> <br />Phone: <br /> <br />7, Person within the State of Florida designated. by owner upon whom notices or olher documents may be served as provideo,'by <br />Section 7,13,13(1 )(a)7, Florida Statutes. <br /> <br />Name: <br /> <br />Address: <br />Ph9ne Number: <br /> <br />8. In addlllon to himself, Owner designates the fallowing perton to recelv. a copy of the Lienor's Nollce as provided In Seclio'n <br />7.13.13(1)(b), Florida Statutes.' . <br /> <br />Name: <br /> <br />Address: <br />Phon. Number: <br /> <br />9, <br /> <br />Expiration date of Notice of Commencement (expiration date is one (1) y,ar from date of recording unless a different date Is <br /> <br /> <br />,."':i.d). Q~ ,,'(;(~ O.Lu A <br />f2IL (-f/1flO L, 'ZEI-I-f5[/Zlo Signature o~ <br /> <br />STATE OF FLORIDA <br /> <br />.,' . I ,I <br /> <br />The fore oing instrument was acknowledge before me this I <br />L t...... . <br />. pGOduced V I.( W /V' <br />(Driver'. License #) <br /> <br /> <br />date of if L5/fJ\./J I~(L , 2012i, by <br />who (Is) (are) personally known to me or <br />uldentlncaUon, who did/did noltake an oath, <br />\ <br /> <br />~A.~ <br /> <br />~.~ Bruce A !\Sbel ^ <br />!~. ; Mycommission0011t:>710 <br />''1;../ Expires June 22, 2006 <br /> <br />Signature . Nolary Public <br /> <br />(A copy of any bond must be attached at the lime of recordallon of thl. Nollee of Commencement) <br /> <br />, . <br />