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, � ` �,���R��� : , I Illiil IIIII IIIlI IIIII IIIII IIIII IIIII IIIII IIIII IIIII Ilil IIII <br /> 201500087 <br /> . ���13����� , <br /> Y A ��7�- -x��%�.�/�` S�Dt- '�' Rcpt:1651725 Ree: 10.00 <br /> ' � �d� DS: 0.00 IT: 0.00 <br /> _ �� / �^�� �/ 3?,y�� � 01/06/2015 D. B. , Dpty Clerk <br /> �y � ( `.'u 7 <br /> ���+��-+� �� �-+������'+����� PAULR S 0'NEIL,Ph D PASCO CLERK & COMPTROLLER' <br /> 010R6BK lg 131 m PG 1952 <br /> Permit No <br /> Property Identification No ��—��' �'�l— d���- �����-"�/ � <br /> THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and m accordance with Section <br /> 713.13 of the Florida Statutes,the following mformation is provided m this IV�'d'��E�l�CO1V�IVV�IEIVCEM[�1lT'T <br /> 1.Description of property(legal descGri,C ion:) C 6�� � �4�-� '� � �d , �� L��`� ��C 7� ` g� l <br /> a) Street Address• S 7/� (!2 � � � l'f <br /> 2. General description of improvements. � �� �...�.J�.�r� �� <br /> 3 Owner Information / / ,�, �// � ��('�/ <br /> a)Name and address: Gvrt'd1 �U�'Jd��� .���'3 p2.�� `f1" �1D�c/�/'�-�(�' �/"`""I`� <br /> b)Name and address of fee simple titleholder(if other than owner) <br /> c)Interest in property <br /> 4 Contractor Information ` � �/ /� � ✓��l� <br /> a)Name and address ��-4� �� �G�-� � �L • �(J 7 �i`-� �� � <br /> b)Telephone No.: Fax No (Opt.) .,�� <br /> 5. Surety Information � <br /> a)Name and address� <br /> b)Amount of Bond: <br /> c)Telephone No � Fax No. (Opt.) <br /> 6 Lender <br /> a)Name and address• _ <br /> " Phone No <br /> 7 Ident�ty of person within the State of Florida designated by owner upon whom notices or other documents may be served. <br /> a)Name and address: <br /> b)Telephone No Fa�c No (Opt.) <br /> 8.In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided m Section <br /> 713 13(1)(b),Florida Statutes. . <br /> a)Name and address• <br /> b)Telephone No. Fax No (Opt.) <br /> 9.Expiration date of Notice of Commencement(the expiration date is one year from the date of recordmg unless a different date is <br /> Specified). � <br /> WA.�2N�1VG'I'�Oi�I�i�l�: r�I�1�'�.�i�'11'I�1V'�'S M[AYD�+ 33X'g'�E OWNE]t�,.�7CE�t`I'�IE�X�IRA'I'IO1V OP'TgYE 1V0'TICIE��'+ <br /> C�1VXIVYENCEIVV��IVT'f4.���1�15k�ER�&�I1VI]PiZ��'�kt IPA�'1@�1E�1'�'S iJI+1D�A2 CHAP`�'IEAt 713,PAllt'I'�,S�C'�'ION 713.13, <br /> �'LOJf��DA S'�A.'A'VJ'fi'�S AIV�➢CI�N�SYJI.'g'BI�I I'OU�t�'�?,�'�1VG'9.'�V�CE�'OI2 gMPRO'6��MEN`%'S T�YOYJR PROPER7['Y. <br /> A IVO'A"�C]E O�'COMIlVI�IVC�M(�IV`d'M�JS'�'B�g2l�CORIDE�AN�POS'TEID O1V'�'I�E�O�SI'I'E BE�OItE'I'HE FTRS'A' <br /> �NS��CTyON. �fi XOU Il>I7C�1V➢�'7C�O�TA�1V IFIN�AIVCIl!'�,COIVS�J�;`&'XO�I�t I.,El!'I)Ei2 OIE�AN A�"TOh2N�Y B�]FOi2� <br /> C�1V&NY�NCTIVG'VV�➢.tK��t&t��ORD�I+IG�'O�JR'l��'g'YC�O�C�1V�1Vg�IVC�IVI�IVB'. <br /> STATE OF k'LORIDA . / / L��/i'/IJ�� <br /> COUNTX OF PASCO �� t � <br /> Signature of Owner or Owner's Authori ed O cer i ctor/Partn /Maoager <br /> L d��� �/ �U.�o��z <br /> Print Name <br /> �T e foreg/oing mstrument was cknowledged before me fhis 18�y of �(lLG�✓- ,20� ,by <br /> L0�/1 U��� as (xl�/�-` (type of authorrty, e.g. officer,tivstee,attomey <br /> in fact)for J � - - ^/- (name of party on behalf of whom instrument was executed). <br /> � c ���� <br /> Personally Known OR Produced Identification �� Notary Signatut b <br /> � � � � <br /> Type of Idenhfication Produced� Name(prmt) v �} �� <br /> Verification pursuant to Section 92.525,Florida Statutes.Under penalties of peijury,I declare that I have read the foregomg and that <br /> the facts stated in rt are true to the best of my knowledge and bel�ef. ` � <br /> FORMS/NOC,rvsd2007 <br /> :?o�!'��•°`°��:�STACIE LYNN HARTVNIG �6'nature Natural Person Signing Above <br /> :•; •� MY COMMISSION#FF064897 <br /> �y'•... '�Qft <br /> �,,�aF�;oa.••- EXPIRES October 21,2017 <br /> (ao7)s98-ot53 FlorldallotaryService.com <br /> � � - <br />