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HomeMy WebLinkAbout0629 ~ i ~ 44~253 c~F~ rii~ I~.Al'E UF-' L~I_!~ I 11 ~~?~wN~~nl ~~.w~l~~ Mu.~ ~~~~a~.~~~~.~~hr ~.~~I~r• p r ¦ OTATf. fllE NO " 1 N\ hN M 1 N 1 M~ 1 111 1 J~ O R 1 D(1 ~ •~1 C~~ ?~~NI 1~1 ~~••~w~ • Rff.15T11Ap S NO ?I~MANINi u~r pltl~~lU Nu.l ..rvr~ 11r u~U ~N tA~n~ a•• UI h~rD~IMH ~W ' I~A[~I~1l~~Lli w,i~wiw.s , NI~RR 0. i A1•11.0 ,.1~,nA lf3 1~)'lb ~AU .w~q M14~.~, ~~1~11 ~M ~a0~~r_ w(.1 uw~~ ~ q~~ o..n~~ . s.. C~1f (N U~U~ , u.w.... n~. COUNI~ lN M ~t11 . 1qto. ~ •-~n~o•• .~N~1~ r01 O~N ww~~ I •M ~ ~ t~'liite 1w__?1- - -1----- 1 ''ept• 2~? ~ 1904 ~3ror,.~r~i-- CR1f, IO~MM. O~ ?OCw110M O! OEi?IN wi»~ a~ ~u.uf NOSh1Al O! OIMU NSIIIUIION - N~Mi ..u~ n~w~, a..~ ~r«n ...e ..w~n ~ !ry(Mt ~If O~ NO Yes 21~64 i~adison St. n lloll~wood_-- - . _ _ - - - _ . S1AIE d W~1N ~u wo~ ~w V.1 ~.~+•r~ CIIIjEN OI WNAT COIMT~Y MARttED. NIY[! MARMI~. SN~VIVlK' SrOUSE ~N G~.~ ~•~N~+ ~ . • ~~h• ~ W R ( Srltr. ~ ~,~.,•~,b~~. , Atichigan ~ ~TSA Stena Phillips - - - - - v..~.~ e~~e.us s«IAl SE~U~Ii~ lN1WE• USWI OCCU?A11p~ ~aa ...o w w.. ea+~ ew~~.c ~ou w Rw0 cN wSw~ESS O~ u+DUStn ~,.~o a.~r rM.wc tu~. Mw u q:,q~ ~ Owner Anpliance Store ~M ~~~~4-03-65$$ ~ti'DIwC1 ~IMM .o..~sti~o» RES~DE?~Ct-SUfE COUr~Tr CIT11, IOM~N. W IOCAhCN - ~~vo~ c~n .~.nf SltEtl 7u+0 ?1N+K~t~ ~ ~s.u,.. .~s c~ ..o. ~•.Florida Broward ~k Holly~vood Yes 24ti4 ldadison St. /A1MEt-HAME ,ni~ r~oa~ t.f~ MOiMtt-wu~0[N NaM[ r~~St ~~oa~ a.t• „ ~eor e Parkdi~]_1 Lora T~ot Available INWRM~Nr NAME rtwKwG /~OO~ESS ~i~nn o~ ~~e ..o. un w•Or.., f~•n. tr~ Stena Rarkdull 24ti4 iiadison St. ~Iollywood, Fla. ...w...... ~~~T 1 pEI~M wwS CwUSED ~Y- ~MtEf OMr p?~E UUSE ?tf lwE ?Ot ~ol. (6). ~ro0 1~q ~~11~~~N OM)~~ •ue N.~r 11 w+~o use ~ . ~7 ,t~- • l.•c. CCt ~~~C ,,~'Q.-4'~~~ c•~`~, 3~' ff. • • N W ~ =OMY~tIONS. I~ •Mt, ~ ¦~CM 6~v~ tH~ 10 - - rr~Ol~~f C~Y4! ~Ol. ~ t0. M?1 ~ COwf~pylKl O~: ~ ti~•nwo rr~~e q~MO C~YN ~~tt kl _ •Utp~ir ~t rEi .~~e ~~~a~..ei co~ Iw~T ¦ QTNEt SK,NYK~, T CON~IIONS td+bnpwt tOMMY1n/G M~~M ~Yf MO/ ~~{~ry0 10 C~VS~ 4tHN W~~~~ ~~e~ ~ es M,,o, ysn~e au~r~..~Ma e•uu N o .l~ / ~`t' fi c-T~s x'~' <; r v S o. e..,. P~cMA~ 1 ACCM[iMl, SUIUDE ATE W ~~OMM. M~, i~~~~ MO~X NOW INIURr OCCUR~ED ~ l~tt~ wry~t Or ~wwn ~w ~~u ~ W~~n u, e1r ~ MO+rK~dE, O! 1M+DEtEW1NEO r ~"M ~a M Me ia ~ IM1U~~ Ai WOR[ ?IACf Of IN1U~Y wo..~. ru., vMn, r+aoti. 10CATION ~ s~un o~ ~ r o »o . on o~ ~o..., f~.re ~ ~ ~snc~n.~s W ro~ on~t~ Msc.f~c ~snc~n~ _ ~b~ ~ ~ : ~ CEttR~C~t~ON- ..o..rw e., ro»~. o.. ~t.~ .~.o us~ s~•~ •••~wr¦i..~ a. ~yr~o~o w~ ro~ oe~tN oecu~elo n.e ?uce. o~ •M~iKIqN: r / 1O / rM~M O~~ rlal ~OO~ ~rtf~ N~~w ~Npy~ 1 0~~~. ~~0. M tw~ ~Ia• ~~M~N~ ~N ` /n ~j % ~ y 7~' d r~ a..O.nlDG~. W' 7N «u~s~e ~~o• ~ ~ ` ~ lt? ~"~~~~~1~ )1. 1C ~ J ~ 71~ II~ / M ~o w uwL~s~ ~uw• C[tiMKA?qH-MEDK~I [x~MU+ER OR COROt+fe o» ~.e ~.s~s a..u rov~ o. w.~w o~c~a•.. ..t ?~o~+w~c~o o~.e ~~ur+~tOM d na qo. ...o/O~ n~f ~wv~sr~c..pn. w r. a~w0~•. ..O~+rw s.. wu• O(aM OCCY~~~G Ow w.f 0~~1 wO OM 10 M C~IM~f~ S~~ryO M_I/,~~~ _ M Tt~ - _ - . _ r p- +~~t-~~~ DAfE SIGp+fp/ ~~r. o.•. nu~ CI~i1f1ER-HIM~( o~ /"'n S~ - ( ~ / • L 7~a- 1` i ~)L ~ / ~ Q / l 0 ~S'~ _s-~ ~ _ - - I . ~ - _ MAKMKiAOORISS-C~RII/K~~ ~ T~,~ti~u~~~Y~i= ~ ~•n~ • ~•.r~ t~• 7~ T t t• ~o r 7) I- L $ r 2 0 ~ ~U~ul. CRE?tA/~0r~. I1EMOwl CEMEIt~r OR CRf?~a~O~r-?~~t tOC n ~ o. ~a.-. v•e ~ s•tcu+ ! $urial 1~plly~•~ood T~~em.Gardens )~oll_y~r~od, Fla. _ ~ 1M ~ - , . ~ - - N N~MF AN ".~o'o ~er f~+~ ~ix'''' Holl ~•rood Fla. , ~ o„~une 19`~K iac~'li~~~on, Ar~~ ~c p . ~ ; Y . ~w ~ tw ~ , o. r Fc~~.w ~ec y~~ti~~• n ~ " fUN I~KI "S/If.N~AIUf! flU~~fS R- SIf,NIj P! . ( 7 Rev. 19?0 ts? G( . ~ lu J t~ ~J. v ~l 1 .1: ~ec r`.E' t } ( ~ % ~ - . . ti _ ~ ~''7 Ly~ ' ~ .'~r~ ' . ~ ~ ~ _ . ~ . ~ - • . ~ ~ . . •~.r' ~ - • ~ • ' : ~ • • ' . . ' ! . ' . ~ ~'r~ s . ~ ' _ r,~,~ ~ i ~ y • • ~ ,y. _ ? ' • - Z . • ~ . + - ~ ~ .n_ e •~~Fdt~~,~.~bT'~-fl~ ~ ,a'~"~ ) ~•'r .3~ ~ J ' • i .'~I . •r..~ . , ' "'A '~5,• , ~''Q` , J A?` s. • - i l;l.l:fll•I~.I, (:tt!'t ~ , ~ ~ . M . 3 t'- ~ I hereb ; above~Co be a true and correct copy of tiie l.ocal Registrar's Y record_~'_t'Ile-,'ft~: Sroward County Health Dcpartment at Fort laiderdale, Florida. ~ ..t ` t,o.: r ~ - • . ~rsf . ~ . _ . t (Wars}i:.~i~ozt_b~~ u~9,~as raised seal of tl~e Braward County Health Dept. is affixed.) ~3'~,s ~ ~ ' t ~ "~~,.S.c- itY~r . ~ y~ • = t;.. ' . s ~ ~ ~i f ~L ~ ~ ~~``a., a 6-~~~~~°'.;:• ~'~~1:, o ea t er an oca egistrar , ~ • ~`r~ f ~ ~ ~ r. ~ ~ `.~'.a, - . ~~ai ~ ~ ~r~,~ ~ pu y ca egis ar ~ ~ a . . _ - . - - - - - I ~ ~ - - ' ~ '~19 22 : Z ~ fLLEL? ~?~ft u ~ s ROLt'~iER p'~CK~A. ~ a~x aRCUr cou~r ~ ~co~ vr~~Qr__~. _ . c~~ 9::k.'. JV~ ?AGE U~ - 44~253 . ~ ~ _ x,~-`` ' f s'V_.:„i ~ ' d~ l