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.'•:1,5 DFRMI'r t{UMHEgt�` �,. ___ } t � -.
111 0015 1 :a-- c 713.
yproperty.and in accordance with Chapter
The'undershgne8 hereby given nonce Chet improvement will be made to certain teal
Florida statues the following mformauon is provided in the Notice of commencement.
I. DESCRIPTION OF PROPERTY (1 egal description and street address) TAX FOLIO NUMBER: �---
nnrrc TRAC_____LOT—_ rr>L� L _ a
SUBDIVISIONb�i�
P•
2: GENERAL DESCRIPTION OF IMPROVEMENT. JE
3.OWNER INFORMATION: s Name
ri a 1 k Tr i u cr 1 a interest in Ptnpert)jtr—'—°M�'
b. Address t n'
d. Name and address of fee simple titleholder Mother than owner)
4. CONTRACTOR'S NAME. ADDRESS AND pxoN cisER- PISr6 c'`1
S. SURETY'S NAME, ADDRESS AND PRONE NUMBER AND BOND AMOUNT:
6. LENDER'S NAME, ADDRESS AND PHONE NUMBER: 0'
7 persons within the State of Florida designated by Owner upon whom notices or other documents may bie served i u F-r- • 3v S r1Z
Section 713:13 (pia) 7.. Florida Statutes: t 1 r I . I . ri 11'' • n
NAME, ADDRESS AND PHONE NUMBER: provided in Section
S. In addition to himself or herself, Owner designates the following to receive a copy of the) ienor's Notice as
713.13 (*),Florida Statutes:
NAM ADDRESS AND PHONE NUMBRR:
g Expiration date of notice of comma n em�ti7 a expiration date :s I yery from the date of recording unless a different date is
specified) r)r T - — s ati^^CFOFCOMIAEiVCBMCIm
.,.vmm� et: m-R TF ran r ant RFSULT
Print Nate and Provide Signatory's Titl om-
Signature Omer ur
Ihver'a Authorized ofter/Mred r/PartnerfManager
State of Flodda�
County of '" 0 1+- Lq E- da of
The foregoing instrument was aclmowledged before me this ' as
By t ' fi S (Type of authority ... e.g . Owner, officer. trustee• attorney in fact)
(Name of person) IF A
For i �S h n r �' m ent wa�% a s exee Ncuted) Personally g no w -Y— or produced the following type of ID:
(Name of patty on behalf of whom instrum
11 1 IRAIBY WATLEY
r rl (--1 �t.l.t�.r Pub9e • 51sts of Florida
(Printed N of Notary Publ:e) (Signature of otary Public) me� m• Ertplras Any 9. 2014
Under'penaldes of perjury:I declare that I have read the foregoing and that the facts in it I
Commission N 00 959743
belief (section 92.525. Florida Statutes). above:
Slgusture(s) of Owner(s) or r(s)' Authorized 011ker Nrector/partnerfflun ;er who signed
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