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il <br /> I <br /> I , <br /> ' . <br /> AFFI AV�T <br /> . Permit I�lumber: Tax Folio Number: �-{-�� ���• �Qb'CX��? ,UO-1� <br /> , <br /> x�A�, �' � � '1 ,' ,�� � . �..�. ,- :� _ -- _ <br /> STATE U�FL(D�tIDA <br /> - COUN'�"Y OF - � � I -- , • <br />� B�oze me,the vnde�ignetl nirtli; ' ; dulY a ; � a take acl�bwledgmeats and ada�,nis�cr ' <br />� �s,pet�onalI}►appe�eti:. - '- .(b�ifla�Cer A�w�), <br /> wIw afte�beiag duly sovorn,t�poses ep�d:�ye: <br /> . 1. Affisnt is t�e(oheck one): Ownesoft6eabove desc�ibe�prapecty; <br /> t�a O�wnar's Authorized Age�t . <br />� � 2. A Not3c�af Comma�accment,a9 gursu�nt to Section 713.13 of the <br /> FlotidA Statutos,hes bCan f�cd f� rding�n thC Pf fiaial ptib�c reC4tds of <br /> . I�Usboroagh Cow�iy.Floride.as t relates to improv�nants to bo made to <br /> •that certain real pmpert3►desai here�rt. <br />� 3. A copy of�id zeconded Notir.e of cn�cement is att�ched hcieto. <br /> • � . <br /> �'l-� . <br /> Af6iant Si ati�e: _ - - � <br /> .. - - -- - - -- :- -. - ,. <br /> �N�:,.���i(`�;�1' � � _�.15�: -- - ;: <br /> - -. � <br /> � <br /> _ ; <br /> _ :� ; , , <br /> � Sbvorn to ap,d snbsc�r�bed be�are me an this � .itay of l .���t,''�-�� 24� . <br /> _ . Y i I/1IC?�.�Sh. - - - t <br /> by C�_ - .wh ie person�aily I�pwn ta me ax 1�as�odueed <br /> - as identification. <br /> . � . , . , ' - <br /> Notary Public�Si�ture: _.`, � ./ . %�'- _ .:!1'� _ , <br /> Pcint Name: � 1 ! �' t �� ��� . ' <br /> My Commission Exp�tres: <br /> ' - � <br /> � ��°�e� Notery Publ State of Flo�da , <br /> �� . Jamie LJ nkins � �� ; � <br /> a MyCommi� ionEEO737.e� <br /> �?orn�°� Expireso5/ 1/2a15 i <br /> , � . - . _ !1/`J'J� <br />