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HomeMy WebLinkAbout2871 ~....y.+~.civ ' ~ . ft~RiQA fTA1'1i1!! OItW'f fORal A1-1t0yi MlowfacNrsd aRd tat wl~ ?y TA~ Fi. A W. DttM COwpoay N.1 JI -19d~ lotlwariti~. fl~tldo ~ . ~ t ? I , ' ~.ot~ee o~ ~~on~~enrer~ent ~ ~ (TO BE R~CORDL~b) . • t.. Property to be improved: ~'Ots 1~ 2~ ~3 and 4~ B.1.ock 2 of Lafarid Subdivieion~ ~ ~ ~ ~accoi~d~.n. g.t;o'.tiie~~~p ~it'o~'"e'~e'~f.~'f:ri'~ie'o~'`~:ea.. ; , o~ the C~.erk of ~he Ci~t Co~ur~- a~. St, . I~uc3.e• Co+un~y~ ~ . ..~.o~l.da~..in.-P1,a~.Aoro~ r ?ap~. .12.. . . ; - (description suf facient for identification) ; • ; • General description of the improvement: C~e,rgi~l,,~a3.~dtn,g,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,~,,,,, ~ ~ ~ ~ ~ ; ~ ~ F~, ; ~ ~ ~ I~Iame and address of Owner: ....Si~.~t~e.~:,_.~T.o~10._~...ki908~~..~.~i~i.A...k~~~..~A~...... ~ ~ J~hn L. Lester ~ . ~ j .................................................1029. Sauth IndZan Riv~er Dr~ve~ _~t, Pi~rce~ Flor3da . ' ~ :t~2~.50 ~ : ~ = Extent of Owner's interest in p~operty: (fee simple) other: ....~~~~;~..~yt~.~~~'~E~.. ~ . _ ~~G~~~... ~~4~'~~Q~~ . ~ ; { ~ Nar?ze and address of fee simple'title holder if other than O ~9G4 OrL 31 ~'~1 l2: 30 z wner : , , • r RUG~R PU11 ftdS. Ci.c~?K . ; . ` Sl,.•LU~l~..CQUti~Y,..E~.O.ftl~!J~. (1f ownership u other than fee simple, the name and address of the fee simple title holder must ~ also be given) . ~ ~ . Name and add~ess of Contractor : ....................k~.g~_?~. I.~e~~...........:...::....................... A ~ ~ _ _ Fort PSerce ~ Fl,~rida ~ 3 iiv-`~~~ ~"r~ .p ~i : ~ ' - : • ~ I~. ~ t Name and address of surety on payment bvnd, if any, and amaunt of the bond r...... ~:.'i ~.~.~.'.'e! w t 4,:~'.~ Z ~ a ~ ' ~ •R~ ~ ~ . ~ ! ? ~ J,~~ ~ , Amound . . - ~ ~ Nnme and address, within the State~of Florida, of a person other than the Oumer signing this ~ S f- notice, designated by the undersigned to receive service of notices o~ othe~ docu~nents: f . ~ • t ' Name and address of pe~son to receive copy of Lienor's Nqtice as provided in Sec. 84,Ofi1(2) (5) ~ ; ~ ; ~ 1 ` Florida Statutes (Optional): . . 1 ; . , , . _ ; Dated this...~~.~:~day of.....D~eanber............ 19.~ ' • E ~ ~ . . ~ - : ! ~ . Si att~re of Owner (or authorixed ~~r~ : ' fo ~J~ ; . p Su6scri6ed and sworn to be ore me this..........r~~ ~ da o ~ 1~'• • E f y ; ,t•"--s Q~;~t'•~;r~ ~ ; ; ' ~ • Not~ry Puulic, Stat~ ot Florda et large ~j • ~ : , ~ ' - . f~Ily Com~nission Exp~ret PAay 17, 1~68 •.2,-l.~~t.-._ ..n:~-~-~.. . •9~'~",~,...~ a•=N ` : My Commission expir~~.~t~ ~t ,?n«K.~,~.. 6 co:...... ~~y ~ ~;~~~a ~ ~ i . ~ 7 : ~ ; . . • ft ; ~ . ~ ; (Add acknowledgment o f Ou,ner) (or authorixed agent o f Owner) aa ~ fa. {I.lfl Elxida Shfrf~ nqrint 4Mf qlt ~oHa ~ ncpd~d aift~ Ib ClKk ~f tM draU Gwf N CHrRfy rR~n pr~fy h IKeN!}~ 7 1~1~~. ~ h Iw~rwr ~.T tMi p~~r, u b+fon r~tww~clN eooRNNN ef aa t~ProweMt oNw d~%rN st ~~f. /UH IMf ~ artiti~l , M~h~ w Ms iMs ~l tM isonr~wMM i~ ~ uu~ P~~or p M» h+NM ~f N» Nts s~d M~et Ma D~+N~ cov7 M wNflwp~~~1s~. # - ' - ~ ~ ~ - ~ ~.~7 tt~t ~~70 . : ~ ~ nt~. ucsNwius ~ua~ ~ I ~ _ _ ~ _ . _ _ - ~ _ ~r' - . . • . . . .~.~+..,-,a-~,R. . . ~ ~ . , - > R s . ~~T `