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HomeMy WebLinkAbout1145 Tn,. 1~- STAT[ ~OARD OR MtAi.Tfi CERTIFtCATE OF DE14TH 143~5`~ • ¦uRUU o~ v~~?~, ~rwn~nc~ srwrR ~~s N~ l•i•l FLOBIDA ord •4~n el T NO. R[ ltT11AR•f NO. ~ prop~tl~ 1. ~Lwt[ O/ ~fATN COO[ NO. 2. YfYAI Ap10~NC[(~1r~IrrrM.L Uw.lw.w foirnr~I~..~i~:..:..) •:~ert~~ ."a .1" 00YMTf Iucie 66-02 ~~~x Florida St. cie e. ~1•e•~ Ss CITII. T01MM.011 tOCAT10M t. K KACE OF OEATN R CnY. TON160R IOCATION a K OEMCE ~~~~~t IMSIDE CtTr lIM1T17 Y610E CITY ItMITS} ~ ri i.. Ft Pierce res QX ~+o O Ft Pierce res No 1. MANE OF trl.« w.s+w. mw.iawf - m~ccr •co•css M06?ITAI OR ~ WSTITUT1011 ~ pierce H~emorial Hos . 61 N. Coconut Avenue MAYt O~ /~nt NjlA~ Lpt a?TE ~twt~ Dq Yw oc~ r phn o~i~?rM . SE% ODIOR OR IIACE 7. YARRIEO ~ MEYE~ MMLLtD - OATE Of MIITN AGE 1ti Itr/ i 1/i0t11 1 TU11 U1m[t 7~ Mi !rt MrtW1) x..r. o.,,. 9... xt.. ~ ~ 1 t • MID011CD ? qY0RCE0 . p 1•~ •i ~ t0.. usu~a occw~noM o~.e ?tr/ y.«~ ~.u 10s- Kwo oF ~uswcss oR wousrRr 11. e~ (8.es.rA+d1~ t2. urQa os ~wr maaim •~e~ •e- ~u r ~¦.a~ ..w N+~•? ~ hk. «n y./ti?en ¦~~~~t . llael[ !wt 17. iATM[II'S NArE 1~. MOTME~'S MAIDEl1 IMME . . •r en~rrit~r 1. w~?s oEC[ASEO Evu w u. i 11~wco IORasI 1. socw. SccubTV MQ 1. s f1oNA yr~ 11w. r. r ulrwl W M~. M+ w~r 8M d~irl • 110~riC~ Sidden - A/6tM Taa~~~~ 1~. CI?Ytt O/ CtATN (~ltr ~rtl aw ~t? ll~t/r pf (e).~ IIRE1tVAL ~E7~EEN dlr~etrf ~~ATL OfA?NMIISCA{IS[D/Ye , ~A~~wTM •u~t [11• IYM[pAT[ CAIISE tl• !~f- title~t• :7 •it~ tl• Q~I~tw. i/s+q. OuE io - •t 3 • r~t~~ ~p~sri~ 1 e e • 1 ~Eo~s e~ • ~ _ ~ : 1~ . "i r~si~t~~r r~ ~j Dlrrt TO (d ~ • . ,I.~ - ~'f'- • f tDl a T~ ~ /ART IL O~M1t SKwf~CJWt Cpi~Rlpai COMliWI~K TO DGiM ~YI Iq~ IIOA7ED 10 M lOUtIML DIY/qt Gpp 1~ ~ ..MAS . lo~N •t- ~ Nt d~at! ~ ' •~O . •i Nhr• " ~ ~f ..rfe~ a.~ f~'- ~ 2ob-OCSUtuENOwMU1MrOttuRnEO. (41taa.errey~b ~11iY11~1/Mr!~+t11~'•~; S. ~ ea~aMr w+cioc ~awicroc . ; ~ . ~ O ? ~ % Q•.• . ~ •f ~ lOr. twt oF Nwr Ulw~. DrI. Yer }y i ~.e~. YUYRT s: ~i . . i,•, a f. , • . . - - ~ a0r. wusr oau~uua mr. rucc os uuusr (s. i•. i. «.e~.~ ~.s. ~ol cmr. TO*M. 01l IOC~TION ' ~ ~ 11~ STATE MMRE AT ~ 110T MMIE ~ Jd A. /~MI. Wld. ~~tt YN-. N[.) ~ IYORK AT MOIlK 21• 1~fpnd~d tlw d~aaMd lioin Mav Ei5 , to ~ ~ ~,T6,5 ~nd fwt 8im ui?~ on ~_.y~! ~j,r+.--_ G~tA ooaurnd it m on tly d~t~ ~t~t~d ~Do~~: u~ te tM 6wt of aq~ kew~bd~~. lroa~ tM au~ ~t~Nd. ~ll ft~~• jk NO~Mri11[ ~ •r• s• 1• (D~Murwk) tt1. It0o11ESS ??e. w?[S~eMEo o..~~.e. • a J e .e e.e•s•. zj.. ~u~u. e~uunoa ZA. wn tk. ~ure as ecwcrur ae eRUU~r 2~ wuTww w.s. r...,~h) (6tw) ~cra~ (syaybt . v. i. tsis u. ~wc~ ~s s~,? ts. wr~ ua. ~~~~u+ri ser.iuTUa Fls ""`SCate3°~teral Home `...1°°a ~a es Ft Pierce F1a. 6-1 Anna Lee Denison d.r. . • I. 'I ~ . , ; ~ hereby cwt~fy this to t» a true and ton~et oopy of the ~oce~ FI L AN :R E C 0 RD E D ~ 4 j rs'record on fib in tfie St. lucie County Heslth Dsps~t.! h~ ~ ~ n,~ f' ~ t~ ~ F i~ R~eros. Florida. , . B O Q E( ; , ' ~YVarr~t Not valid unless nised seal of. ths~ St. (.Nci~ - ~ . ~ ° . ~ ~,~rn oe~~ ~~X~a.~ '66 ~ I 7 PM 3 2 . ~ • ~ ~ j t _T ~ ~ Z ~t l~.~ ~ ti. o. M~u~, u. 14365`~ County Heahfi officst d~ local Re~istnrR 0 G E r: P~ ~ T R:~ S. C LE R K- ~ Y.\ p ST. LUGIE C~ U N T Y. -,,..,,.-i, - 1 ~ -~ob ~ . . C..,,~..~f i ~ ~,5~_FLOR10a ~ D~ ~P~+~Y ~istrat d . , ; aooK 140 542 ~ _ - { ~ = . . - ~ . . ~ _ ~ M