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Z . SMITH, CLERK Off' THE
417R3677 OBC�ox 3r
CIP=IT COURT s•,,•i�g. ••..__--01:34 PM
p'�E 2293, Recorded 03�D IAi
SCANNO
�Y
U 9 J.
$T. LUCIE 1 Y
THlS SSTO Ci:ATIF(T�IATTNIS IS A
TRUE AND CORRECT PY OF THE
ORIGIN
at
AR�2 9t 26% '
rj CE 01p C(1N111 & C MUM
The undmi;-a hereby even notice that improvement will be Made to MTM'n real P-MP"ty, and in acaordanoe VAth Chapter 713.
Florida statutes the following infostnatioo is provided in the Notice of oomtnencemertty S11 cP L 7 a) QUO
1. DBSCRWn0N OF PAOPESTV U.it al description and street address)1AX tPOLIO� NUMBER: LP
CitJT✓I`�
SLA - rK _ — TPACT�OT---���I' ` '�UI3Fii
ctjRs175ffSiONV � --
2. GRIMMAI. DESCWTZON OF TMPIiOVEMENT:
f�iZ �1
i_ OWNMINFORMA'i'IONt a. Name
ress Bl �
b. AddL �%
d. Name and address of fce simple titleholder (if o
ther than owner)- � .
4. CONTRACTOR'S tKt'� � AVDrMS �� Arm R.�"`C � =��
l 0 vu
'-�r
n
c. iRterest it) pioperty!:L
5. 3URMVS NAW, ADURFM A NO 1'HOXE NUMBEIt AND BOND &MOUNTI
6. LENPERIS NAME, ADDS AN17 PHONE NUM13ER;
7, Persons within the State of 1~lorlda designated by Owstcr upon wbom notices or other docurments may be served as provided by
Section 713.13 (1)(a) 7., Florida StaWms'
NAME, ADDRM AND MOM iVt WER:
S. In afttion to himself or hemelf, Owrser deftnatt:s the following to recdvo a copy of the Lieavr s Notice as provided in Section
713.13 (1)(b), Florida Statutes:
NAW, AI)DX L% AND PHONE NUMBER-
9, Expiration date of notice of cottunencemiont (tlte expiritiou date is l yesr from the date of recording uoleea a 4ffiff ent date is
specified) --,20
Signature of Owner or Print Name and Provide Skmatorfs 11 e!(TDice
Owner's AuthoOxMtCIR{cerlD1rector/Partntr/Manwr
State of Florldp
County of r' Q
p
The foregoing insuumem wasacknowledged before the this � d of
By I . A as
(Name of erao) (Type of authority, __e.g_ Owner, officer, Trustee, auomey in foss)
FoP�(�r��f`lGt� .
(Nagme of party on behalf o whom instrument was crtoctued) crsortelly Known
or produced the following type of ID:
C 4sAh'K !"(�f j
fJatu+YpubNG�M+d�a
(Printed Name of Notary Public) (Sigrrsarre of otaty F ,
My 9bCyrr koog
n EE 22�ttiti
E�t� 7pft?lZOt6
or
Under ponaldes of pr OM, I declam than 1 have read the foregoing and
knowledge and
belief (section 92.525, FI(vida Statutes).
Signstrtre(a) of Owners) or Owner(a)' Authorized Officer10lrector/Partner/Mattager wbo signed above:
tkr, ON9tvt W(Recordhg)
gyLS O ro-1 we & __ t� 01