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HomeMy WebLinkAbout2147 ti~ ~ 226Q8~ ~ ~ C~~::=IC.=.:'._.^.= DcATi-i arpw~~ewl ~ ~ I~rl~n ~no :Cci..{w1.~~l~re ~ctv~cc~ iTATi ~{LC NO. ~..,~.,.~K ~.,.iu~ i.v: Za7 3 Tt~f, O~ I~~hl ~M °1~~~~°P~'~° • NEGI6TRAq•i NO. ~93 IiiMwAiN~ IAK ~CEw3ap-M.W( ~~~f~ ~ v... yil ~OwiE OF DfwTe~ ~•owt~, ~.r, ~ kt w:~Wl ?W T T v. . 1 ~ ~7 n~7 r11•wt~d ~ L~Vi.':..I.u ~:.~.:ti _:nvv ~t 1.a1@ 1~ J112~:@ 2!~ 17(~ uCE ~14q. ~+~~4~+ ~M~+. AGi-.~U J~ E OI i~a7n iw0~•!~. M~. ',CONNTr O~ OEAiM bOQ2 ~~t. ~wcvn ;1'rite ~'~...y .~.~~~~'-.oi ~ +w..s , . • ' d~ . ~,~~.'~GQi:,. St . Lt:cie Giv, tOwn. WI ~OGtWH Of DEwiN c~+. ..JSa.:w. Oa O:na+ wS7.i~Tn"H+-~+.wt .a ~ar~. am ~rr~~ w.wu ~ ~ va~.•. .e~ u• .w ~ ~ Fort Pierce i;o :s ~~y~=. Indiar: r~iver Drive SGif O~ WIM ~ r.p~ r v~•.~•+~:Gi~2En Ot wnw; CJ.~+.~ir cJ. n:vi: .a.:i.iD. ~S~MVnwG S/OUSE ~r ~w. Y?NM M111Y 1 cOw~n , w.:.` :J. 3A'~.CEJ . vK~n i ~~....~~a.ce ~ Indiana ~Jel - ~E(~ ~diL'n :i. .SC}:UC:c~e: .r.e al~.ua S«~K SfCVVi~ Wr~E!-~uSWI G'~u/~i.G~. .....a ...o or..o.. .w+~ n,•,..c w~~ ~w 1 p WS,nESS pR ~WUSiRT o:c~..ro ~ ~ rou...:...~..... . ~ : .~,.,,,..a..~... ~r 309-10-2g29 ' ' " a~,,,,,,~ ~~k :•.~rc':4: ~ ~,b eed Store iES~OfnCE-S~wiE COunir ;~~:r, :J~~ti, Oa .C+:.w;~,,^,n. ~++~w c.n .~.HS Si~IFt A/+D N1i~~f~ ~ ! w~c.~. .u a w~ T FIa: i~a St. Luc~e =o~t P~a~ce No ~~..9905 S. ~ndisn R;ver . /A:tit~-A~.~S r~Ur ~.Oi.~ MJSnfi-I.4IJlN N~YI ~rf~ ~M~ V1~ L~ • „ Fred - "'r~cv Rose - Eeck ~ WOM~wnT-MM~E w~r.."."v w:.:.3iSS o~ w. c+r w w~.., u.w, ~r~ Edith ~racy 5;G^ Sc. in~iar. River Dr. For;, Pierce. ~ /wtT L OEwM WwS UVSEO ~Y. iv~i~ ~M::~ ~w U..SE 7fJ ~wf FOl j~l (?1 ~K~ (qi i IC •••wa....p ~..•u... ?w.uw o.~u ...a o~.a µ ~~ww 41n~ I y % ~ • ~ ! . . • wi+T. - ~o_a,..o.,......, j ~ f .o . _ ~ ~r~ i ? c~ C~4f~ I M W. Ow! ~ CO+LGWKI (Y ~~~~~w0 ~w~ ur~~~- I MY C~YM \~~1 ~ ~ ~t~ ' ' ?wti r Otr+E~ SK'iNY~CwNi COhO~f10r.i~ ewan.r.~ cu+'•~..r~~ ro a~.~~ .ror •a..r.o ro e.rsr en~. ....u . w~ . A11tO~S~ ~i ~ES r~.e n.a.~e~ eo.+- i ~.•~f W+V ~ Yw~lo .ti Nr~~~.w.w0 4rw ; ' ;1M ~~G , or 1uu '~H ` .v..we~.: icC~[wi. S~KiJF-bl-r~Yf~ T . ~a..r,.. c . a.~ ~ rv~a ~~nOW ~r~hi~11 OCCNf~EO ~ ~•m~ w ~w~~~ u. ru~ . o~ rui n~ ~ nJM~v.~f. pl yhl[ItWWD 1 ~ E l~+t~M j ~ ' ~ ~ 17:~ ti 3! v~wiv ~l wOR[ ?.wCE Of ~wNl~ rJr. )~4~i, ~KS~~r, ~vCAi.Gh ~ ~nu~ a ~.r .o.. tm q ro~.. ~r•n ~ ~ ~N~C~n O~ w01 iOnK~ M~G..1% ~VK.n~ € S. ~7M - '.:-s i CfiT~iKwT'ON- .OM~ M. ro.n. p.r •w f.r O.. ~.~/ao w0~ .w~ ~i Dt~iw OCC~~!(O e.~ r.Kt. O~. n.~ /M/3KI~M: ~G~rw Y~ ~tY I~00~ Y1~~ M~M ~~0~~~ C~1~. ~+Y. q 4~ N~~ ~ ~ .rn..~eo rw~ T~ ~ e.....~...ou. w~ ~ n. o~~....o..0.._1-.:iQ=~7 7~ e-~=-70 o-2~i-70 {~u In.S d. M.o..<<..,~.~.~...•,~ CEiTr~Cwi~Or~-w~EDdwl ERw~wr.E~ Oi COa~.fa u.. c• ~r wp~~ J~ W~rw a(f:~w~ ~y ~pyq~K~~ N~! ~ I~uw~~~O+ W M ~Oe~ ~M/O~ tw~ w~liTY.~~.ew. OIw:O+. ( ~ ~O`~rw C~~ ~1~~ ~0~~/ '~j ~ i~ 1.: DI~M1I OCCU~I~O Ow ~M N~l ~r0 OM N nM 4YN'~f~ 1t~ryD . J ~ . M 2i~ / / V \ 1M T't ~ Cfafd~ft-ruTu~sE m.~ o• ....n " S.G~~7u:F ~ ~cm d xr ; Ow7E S~Gr.EO~ 1+o..a, o....w~ . ~_~-.10_~_~~ ` a51`^S~ :.c L i'~ -;?+%LV[/~ 7~1~? tk .L~/~r~~`i c. ~ ~ a ~o-.. ~..n n. ~ ?v~'~wG AD:~~ESS-CF+IYIER t~ ~ ` rcaa^ ~~r= 7= ~r ~ ri ~ i,,:cwi. C4MATi0~+. ~fMOYIU CiME:c:r O: C•cw~;~:~t~-.~av: ~OC..~iw"N+ cm a p~. wu F ~ riCY` ~ ~ ~ ,a tZe,:,ov2i `C:.^. ~i_ :.C.".:@`..e:'V I:., St:I2rL cloriGa ~ _ _ ~ DATE ~ qu~ flihiiwi nJ~+[-na.v; ~1~;~ ,.J..:c:1 . a~uu a. wo o*r o~ rO~w. ~~~re. i.~ ~ ~ + H~ ~~~1~~7~ ::s~ a.C: ~ ::.'.r?'_^.=~ ::~'":E 1v12_ Yr.dia:.~OYJZ: C~G~. Stuar~. Clo. £ S. ro 12 runE~ew:,~~~ECt~e_yLr.~ruiE . t.:G:a'- -5..:.~.;,,K l 1 o•rE ~tcf~.eo n.oc.~ ~te.s~u~ ~ Aw.1970 7t~ ~ 'as " ~'l- • , ~J.~ 1a .TI:ITe 3^ ? q7(} y.~r 1:- _ ~,.c....~ ~ ~ ~ ' F~reby osrtify this to bs a true ~nd c~s+ect copy c,' tts~ Lo~l ~ Refli:tr~ra record on file in the St. Lucto County H,s.~:t5 Dc,~ ~ m~nt ~t FoR Pierce. Flotida. ~ (Warnin~: Not vsltd unless raised swl os the St. tuc:o • r County Nealth Dspartmer?t is affixad.) N. D. MIIIER, AA, p. ~ i~ ~ ~ ' Camty Healrh Off"~car ~ Loca! i.t~istrar ' ' Dsputy Local R:.qistrar . ~ ~ ~ = tooK200 rac~2146 ~ :y; ~ , - _ i a ~ : ~ s ` _ ~ a.~,'~"."~~,~~. _ .U. _ . . . . ~