HomeMy WebLinkAbout2295 . . i
PLORIDA STATUTtf D~EW'S fORM M-140~/~ Manu(oct~rcd and lor tals by 1M H. 3 W. S. Orer Compony
e~ _ )ecksonrill~, Florldo
~ ~ ~~~~~3~~
~ ~r.
~ / ~
~~~~L~ ~~i~l~~i~~~i`il~i~l '
(TO B~ RECORDED)
, ~ Sh'S AT.~ACHED SC~iEDUI~ "A" )
. ~
Propert~~ to be :m¢roved: ~ .
~ ~
(dcscription st~/ficient /or iderttification)
One story Cffi Building
C.~ncral dE~scri¢tion of thc i~nprovcment-
?
t
i
F~rt Fi.erce Lodge ~1520, Benevolent & Protective Order
1~'antc~ and addr~ss of Ou,ncr: ---t~f--B~lt$-~--t~--i~ni~ed--St,a~eB--o~--/~me~~ea-------------------------------------
Post OfPice Box 20g "
k'oxt__~~ex~~,--k'~.Qx~,~~--------------------------------------------------------------------- ~
, ~ • • • > Fee Sim le ~
I:.~~tcnt of Ou,ners intc~rest :n profiertl (fc~c~ srmplc) ofhcr- --------p-----
~
Namc~ and adtlress of fee sim~le title holder if otlter than Ozuner_ ~
~
F
S
•
(If ozcnershi~i is other than fee simple, the namc and ad~lress of thc fec sim~le title holder n~ust
also bc~ ~~iven) ~
i
t
N~mc~ ant! address nf Co~ttra~tor: MiB~_.a??a__Lester_ Canstruction__Comgany______________________________ ~
2Q07 Okeechobee Road, Fort Pierce~ Flor3.da ~
~
~
11'nm~~ a~id address of s:~rc~ty on pa~'r~ie~it bo~td, if any, and antoi~rtt of tlte bo~rd- ~
. ~
~
,
2
f~ I)I011)lt ~
~
11'ame a~id address, within thc State of Florida, of a person otlier tlia~i tlic Ow~tcr sig~ti~tg this :
i, notice, designate.d by fIIP. undersigned to rcceiUe serr~ice of ~zotices or other docuntents: :
;
~
,
Name and address of ~ierson to receive copy of Lie~~or's 1Votice as provided i~i Sec. 84.061(2)(b) ~
!
,
Florida Statutes (Optional): ---~t.__~ucie _Crnuity-Bank---------------------------------------•--------...------------------ ~
Fort Pierce, Fl.orida ~
Februaxy
Dated t/tis.----~~~/ida)~ of------------------------------------, 19_66---• Fort Pierce Lodge ~1520, Benevolent
& Protective Oxder of Tlks~ of United States ~
ATTEST: , Americ
- - - - - - -
-I ~ ' ignature of Owfier (or at~tliorized age~it)
'
Sttbscribed and stuor~t to before ~~te tftis--------~~--~--- a' of-- February-------------------•~ jg-~---
%
.
__.~'1~~
~ ' -
's"-'", . ~ ~ Nota~ P:cblic
ll~`)~ ~(S . n ~ : Zl ~ - / ~ y ~ f
` ~~t i lSeq ex :res------------------------
. - ~
: ..`c,~\ a~.~.~;~~ t. ~
,"~/'t~d _ acknowledgment of wner) (or autho~ized agent of Owner) ;
~ f~ ~ ~ ~ C ~
- ~a~.• 84~1~ ('.oridc ~/t~utst /'QVIRi fhat this noliu bs ncorded rith Me Clerk of tha Urcuit Court aF Coanfy wh~r~ property it locoled prior fo commenciny i
'`to:imprere~c:+y caol ~pr4p6~1y,=u befon recomMSncinp complation of en improreer.ertt oft~r defovtt or abondonmenl. Alto thol a cerlified cop~ of ihis nolice (
-~Ls;p~e6 c~`Ih~•site o~tMt"in~P~ove~enf in a cca~picvo~t placs on the front o1 ths site ond thol the Fo~fad covY b~ weathe~proefad. ~
_ _''.h _
,l • ~ J i ~ , y << _
ti, ~
i~` ~ • ~ '
% -
. ` ~ ~
- ~ /~K 138 LAjn
. ~`4.~a~;,~.s~..~~,~ ~~7
r ~ ~ ~~l' , i
.