HomeMy WebLinkAboutNOCAFTER RECORDING -RETURN TO:
1
SGA[dNVEAQU
PERMIT NUMBER: BY
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The undersigned hereby given notice that improvement will
Florida statutes the following information is provided in the
1. DESCRIPTION OF PROPERTY (Legal description and
2. GENERAL DESCRIPTIOWOF IM]
3.OWNER INFORMATION: a.
b. Address(
d. Name and address of fee simple titleholder (if other than
4. CONTRACTOR'S NAME, ADDRESS AND PHONE NI
5. SURETY'S NAME, ADDRESS AND PHONE NUMBER
6. LENDER'S NAME, ADDRESS AND PHONE NUMBER
7. Persons within the State of Florida designated by Owner upo
Section 713.13 (1)(a) 7., Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
8. In addition to himself or herself, Owner designates the
713.13 (1)(b), Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
9. Expiration date of notice of commencement (the expiration
specified) , 20
of Owner or
Owner's Authorized Officer/Director/Partner/Manager
State of Florida
County of
The foregoing instrument was acknowledged before me this
By L,'1 j ()k (\n UP—rLCAL\J e
(Name of person)
For L ; (, Oy\,A � r Aqn&r Z
(Name of party on behalf of whom instrument waswas executed)
J_'co-w- (b O'lec
(Printed Name of Notary Publ e) n t e of N
Under penalties of perjury, I declare that I have read the
belief (section 92.525, Florida Statutes).
Signat of Owner(s) or Owner(s)' Authoi
PO
Rev. 08/30/2007(Rmording)
JOSEPH E. Sir CLERK OF THE CIRCUIT COURT
SAJ,NT i_UCIE ..,NTY
OR BOOK 3852 PAGE 1313 - !3• 3 c'-ic Tyre: � C
RE.1�0RI"ING: S10.00
made to certain real property, and in accordance with Chapter 713,
ice of commencement.
address) TA NUMBER: NUMBER: 7.(�r �. i7Do
LQT _ BLDG UNIT
c. interest in
fl, <
►ND BOND AMOUNT:
whom notices or other document may be served as provided by
to receive a copy of the Lienor's Notice as provided in Section
is 1 year from the date of recording unless a different date is
Print Name and Provide Signatory's Title/Office
day of :ibr-t, olr , 20 _.
0LAJn-er
(Type of authority... e.g. Owner, officer, trustee, attorney in fact)
'ersonally Known_ or produced the following type of ID: -,✓erJ5
Notary Public
State of Florida
ar Public My Commission Expires 05/2012019
y (Seal) Cornmisslpn No. FF 232997
Bonded through CNA Surety
g and that the facts in it are true to the best of my knowledge and
Officer/Director/Partner/Manager who signed above:
By