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~ot~ce OE ~o e~~teitt
fT0• S[ RECORD[Ol
Prope~ty to be improved: .~ts..~..8nd.,6,,__Blo~k..~~..~~:~~'~..~~,~~,Qm~...~~card-
~.ng--~o..Pl~t_.~auk..2...~a,ge...1l~,..St.....T.uci~..C~avnt.~r.,..Fln=ida...--•
(descre ption su
f%icient Jor identi
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ication)
(;e~neral desc.ription of the im p~oaement: . 0?~4~~$~4~y...~?~~~~. ~I~A~~]C _ Q~~~.C~. ~1i~.ldiIIg.
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A'a»~e and address of Owner: __Charles._W. CrookB and Leah._~,,._~;QQ~~,,...~,~g_.~~,f~,
- ~._..~~oQ~~_ ~..._Q~...BQ~t__ ~11~ Ft_.._.Pierce F1nri~cia..33J~5II
and y~- - - - - - .
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F_.rtcnt o/ Owner's interest :n property: (fee stmple) other; ~~__3~~111g1fl
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1~anie and address of fee simple t:tle holder if other than Ownes_ ____________________~.c~..._.____._._______.;~~o
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(I/ ownership is othe~ thare fee simple, the name and add~ess of the fee simple~titl~e hol~ mu~~m ~
ulso be ~iven) o~ w N
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11'amc~ and address of Contracto~: Dink Herrel • ~ ~^m
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1~'a»ie and address of susety on payment bond, if any, and amount of the bond: ._NO__BOND ~
~ Amount
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~ 11'a»ie and address, within the State of Florida, o
f a pesson othe~ than the Ownes signing thu
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notice, designated by the~undersigned to seceive tervice of notices o~ other documents_
Send notices to owners
713.06
~'ame and add~ess of person to ~eceive copy of Lienos's Notice as p~orrided in Sec. 8~:~#{2)(b)
Flo~ida Statutes (Optional): .._~'~C,?__~?x~t3l~._k'e~...~~..Q~..B~x_1DQU~__Ft~_.~ierace.,.__.._....
Florida
Datcd this_..~5._------daY ol------------------------~9.-..., 19_ 6~
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Signatuse of Oumes (or authorized a$~~tt~;,,,,~ t
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Subscribed and sworn to be o~e me thi.t....._. ~ .............da o ._...1'~A. _:a~' 9:B~R~•. ~
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