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<br />111111111111 1111I11111111111111I111111111111111 11111 11111111 <br />2007076242 <br /> <br /> <br /> <br />1. <br /> <br />2 ~ General Description of Improvement <br /> <br />Rcpl : 1096076 Rec: 10. 00 <br />DS: 0.00 IT: 0.00 <br />05/02/07 Dpty Clerk <br /> <br />3. <br /> <br />O\...ncr Information: Name[flPl/YtJ JI~J1/ ',: <br /> <br />Mdr.ess S 3~ (, '4'1']" ..Jn~itY Uhif f ~,1 state1i'l1 <br /> <br />Interest in Property: JlI4 <br /> <br />Uame of Fee Simple Titleholder: .Nil ~~90~~~~M'~':ll~C01CO~~Tl CLERK <br />(If other thfLln owner) OR BK 748~ PG 1208 <br /> <br />Nil <br /> <br />Address <br /> <br />R. <br /> <br />Contractor: Name <br /> <br /> <br />City <br /> <br />State <br /> <br />Address ,'11 (o~ {" JtdJ (#.S.iJ <br />s. '., ..' ~u~~~I:~01~~ ......t1L.II. <br /> <br />"....::..,...:>:~::.-.. ..'" <br /> <br /> <br />Address <br /> <br />City <br /> <br />Stat.:! <br /> <br />6. <br /> <br />Amount of Bond: S <br /> <br />JVII <br /> <br />Lender: llame <br /> <br />Address <br /> <br />City <br /> <br />State <br /> <br />7. Persons within the State of Florida designated by Owner upon wh <br />notices or other documents may be served as provided by Secti <br />7!3.13(1)(a)(7), Florida Statutes: <br /> <br />tJt:mc AlA <br /> <br />J\ddil?SS <br /> <br />City <br /> <br />Stat.e <br /> <br />8. <br /> <br />In addit.ion to himself, Owner designates <br /> <br />If4 <br /> <br />of to receive a copy c= ':' <br />Lienor'sNot~ce as prov~ded ~n Sect~on 71J.13(1'(b), Florida Stat~tc. <br /> <br />I). f"xp.i:nt ,L'Jf1 dnte n! ltC/t.ice or Commencement. (t.he expl..cAtivn d.:te is 1 ve.: <br />fr~m the ~atc of recording unless a different date is specified.) J <br /> <br />tikJ dJJ--- <br /> <br />~ig;tature of Owner: <br /> <br />~-~~~ <br />i JENNIFER EDGEiiijii .....! <br />: ~",""'I:~ .. <br />: l;''ff:.''~ ean....~"^: . <br />: = ~~. - e.,..",fn('~~ .- <br />. -':'- - <br />: ~o:t'.. 741 BondecIlIIIlI-...., . . <br />. ~~Qf:f\.~~ _' twVV/ : <br /> <br />Sworn to and subscribed befor~ me this <br /> <br />20JYl . <br /> <br />Not.:lry Publ ic : <br /> <br /> <br />............................... .. <br /> <br />""j ."l <br /> <br />PC93OS304aIA <br /> <br />......... <br />JENNIFER '''GBMN <br /> <br />_ CIIIIIlI........ <br />. ........ <br />....... <br />...... ~~. <br />