102 Gleason Cove - BR18-002715 - FENCECITY OF
INEW
IV SWORD
FIRE DEPARTMENT
n -T, -
Building & Fire Prevention Division
JUN 15 7015 RESIDENTL4L FENCE PERMITAPPLICA TION
1 L)
Application No: f 'g 115
Documented Construction Value: $ 2,638.00
Job Address: 102 Gleason Cove, Sanford FL 32773 Historic District: Yes No
Parcel ID: 02- ZO 30 - 52.3- 0000 - i2"7 O
Plan Review Contact Person: Jannice Torres
Phone: 407-900-2940 ext 1007
Title: Permit tech
Fax: 888-864-2785 Email: Jannice@mossyoakfences.com
Residential Fence Information
Type of Fence: Wood Metal PVC/Vinyl 0 Iron Other
Fence Height: 3 Feet # Gates: 1 Total Linear Feet:
Additional Information: 83' of 6'H PVC fence with a 5' single gate
83
Fences with a height of over 6 feet will require signed & sealed structural engineering"
Name Jennifer Allen
Street: 102 Gleason Cove
Property Owner Information
Phone: 407-256-0715
Resident of property? : yes
City, State Zip: Sanford FL 32773
Fence Contractor Information
Name Mossy Oak Fence Phone: 407-900-2940
Street: 271 Southridge Industrial Dr. Fax: 888-864-2785
City, State Zip: Tavares, FL 32778
Please Note: The Building Department does not perform site inspections on Residential Fence
permits. A signed and notarized Fence Affidavit is required to be submitted along with this
permit application. Please see the attached Fence Permit Submittal Guidelines.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR
AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Effective: August 1, 2017
Application is hel•eby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction
in this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools,
furnaces, boilers, heaters, tanks, and air conditioners, etc.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 511 Edition (2014) Florida Building Code
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property ofthe requirements of Florida Lien Law, FS 713.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
Zql- M 513ohe
Signature of Owner/Agent Date .gnature of ontractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Brandi Miller
Print Contractor/Agent's Name
s61,g
On ature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
M' "''•., JANNICE MARIE TORRES
Commission I! FF 158171
Expires September 9, 2018
Boned TinrmyFain9auow900J95.7019
BELOW IS FOR OFFICE USE ONLY
50A__
PLAN REVIEWAPPROVAL: PLANNING:,,r,LL HISTORIC:
COMMENTS:
Cl, to install approx. _413 linear feet of 6 foot high
r rivw:y fence and gate(s) as shown or. plan. Fence
shall, be constructed with finished side facing outward.
Effective: August I, 2017
PERMIT##:
CITY OF
S.ORD Building & Fire Prevention Division
FIRE DEPARTMENT
RESIDENTIAL FENCE AFFIDAVIT
6 FEET OR LESS IN HEIGHT)
ADDRESS: 102 Gleason Cove,
Sanford FL 32773
1 , HEREBY AFFIRM THAT ALL OF THE FOREGOING
INFORMATION IS TRUE AND ACCURATE. THE FENCE WILL BE INSTALLED IN THE APPROVED LOCATION AS SHOWN ON THE APPROVED SITE
PLAN. THE FENCE WILL BE NO HIGHER THAN 6 FEET, MEASURED FROM GRADE. THE FINISHED SIDE OF THE FENCE IS REQUIRED TO FACE
OUT. IT IS THE HOMEOWNER'S RESPONSIBILITY TO VERIFY THE FENCE IS PLACED WITHIN THE PROPERTY LINES AND ANY DISPUTES
BETWEEN ADJACENT HOMEOWNERS WILL BE A CIVIL MATTER. I UNDERSTAND THAT FAILURE TO PROPERLY FOLLOW THESE GUIDELINES
AND ADHERE TO ALL CITY CODES (SANFORD LAND DEVELOPMENT REGULATIONS, SCHEDULE F) COULD RESULT IN THE FENCE HAVING
TO BE REPLACED, RELOCATED OR REMOVED AT THE OWNER'S EXPENSE.
FENCE CONTRACTOR
BY SIGNING THIS AFFIDAVIT, YOU ARE ACKNOWLEDGING YOU HAVE MADE THE HOMEOWNER AWARE OF THE FENCE AFFIDAVIT
STIPULATIONS AS STATED ON THIS DOCUMENT.
COMPANY / CONTRACTOR: Mossy Oak Fence/ Brandi Miller
CONTRACTOR SIGNATURE:
HOMEOWNER (OWNER/BUILDER)
OWNER/BUILDER NAME:
OWNER / BUILDER SIGNATURE:
PLEASE NOTE"
DATE:
DATE:
THE BUILDING DEPARTMENT WILL NOT CONDUCT ANY INSPECTIONS ON RESIDENTIAL FENCES. THIS
AFFIDAVIT MUST BE PROVIDED, SIGNED AND NOTARIZED, AT THE TIME OF PERMIT SUBMITTAL AND WILL
SUFFICE AS THE FINAL INSPECTION APPROVAL FOR THE FENCE.
STATE OF FLORIDA COUNTY OF
Sworn to and Subscribed before me this day of
identification)
Signature of Notary Public
State of Florida
Print/Type/Stamp Name
of Notary Public
by:
Who is D Personally Known to me or has 0 Produced (type of
as identification.
SEAL)
Effective: August I, 2017
Building & Fire Prevention Division
FtRE,DEP/1tt7ME1VY.
RESIDENTIAL FENCE AFFIDAVIT
7 (
6 FEET OR LESS IN HEIGHT)
PERMIT #: 1 v ` ADDRESS: 102 Gleason Cove,
Sanford FL 32773
HEREBY AFFIRM THAT ALL OF THE FOREGOING
INFORMATION IS TRUE AND ACCURATE. THE FENCE WILL BE INSTALLED IN THE APPROVED LOCATION AS SHOWN ON THE APPROVED SITE
PLAN. THE FENCE WILL BE NO HIGHER THAN 6 FEET, MEASURED FROM GRADE. THE FINISHED SIDE OF THE FENCE IS REQUIRED TO FACE
OUT. IT IS THE HOMEOWNER'S RESPONSIBILITY TO VERIFY THE FENCE IS PLACED WITHIN THE PROPERTY LINES AND ANY DISPUTES
BETWEEN ADJACENT HOMEOWNERS WILL BE A CIVIL MATTER. I UNDERSTAND THAT FAILURE TO PROPERLY FOLLOW THESE GUIDELINES
AND ADHERE TO ALL CITY CODES (SANFORD LAND DEVELOPMENT REGULATIONS, SCHEDULE F) COULD RESULT IN THE FENCE HAVING
TO BE REPLACED, RELOCATED OR REMOVED AT THE OWNER'S EXPENSE.
FENCE CONTRACTOR
BY SIGNING THIS AFFIDAVIT, YOU ARE ACKNOWLEDGING YOU HAVE -MADE THE HOMEOWNER AWARE OF THE FENCE AFFIDAVIT
STIPULATIONS AS STATED ON THIS DOCUMENT.
COMPANY / CONTRACTOR: Mossy Oak Fence/ Brandi Miller
CONTRACTOR SIGNATURE:
HOMEOWNER (OWNER/BUHAER)
OWNER/BUILDERNAME:
OWNER / BUILDER SIGNATURE:
PLEASE NOTE"
DATE: 6 Ian 114
DATE:
THE BUILDING DEPARTMENT WILL NOT CONDUCT ANY INSPECTIONS ON RESIDENTIAL FENCES. THIS
AFFIDAVIT MUST BE PROVIDED, SIGNED AND NOTARIZED, AT THE TIME OF PERMIT SUBMITTAL AND WILL
SUFFICE AS THE FINAL INSPECTION APPROVAL FOR THE FENCE.
STATE OF FLORIDA COUNTY OFe-
Sworn to and Subscribed before me this day of fAt7420 k? by: YAyc-
6-1i 2 . Who is 9'Personally Known to me or has 0 Produced (type of identification)
as identification. CSInature
of Notary Public ate
of Florida (SEAL) c
T` JANNICE
MARIE TORRES Pr
t/Type/Stamp Name = Commission # FF 158171 of
Notary Public Expires September 912018 19 R
9oKeAllwim/Fab6suarce Ffr
r$;vr Aviamt I ?m7
SFMINOLE COUNTY
FL(VA)AS NATURALc] 141 BUILDING DI VISION
FENCE IN EASEMENT ESTOPPEL
RE: ESTOPPEL LETTER AS TO FENCE(S) CONSTRUCTED IN EASEMENTS)
JOB ADDRESS:
I/we, the owner(s) of the property. relating to the above referenced address am/are signing this
letter as an inducement to cause Seminole County to issue a building permit for my benefit. I/we
represent to Seminole County that I/we have the authority and power to execute this letter as
owner(s) of the subject property and acknowledge hereby the following conditions that this permit
is issued upon:
That the fence to be constructed is located within drainage or utility easement dedicated to the
public.
That I/we will allow unlimited access to the easement area by County or utility company
employees in order that the purposes of the easement may be fully effectuated.
That, I/we will not impede or obstruct Seminole County or utility companies who have rights to
the easement area from fully exercising their easement rights.
That, if either Seminole County or an authorized utility company removes the fence
constructed under this permit application due to my/our failure to remove it within a reasonable
amount of time after formal notice is given, any loss or damage to my/our property shall be
my/our responsibility. It is my/our responsibility to insure that the fence is removed in order to
provide use of the easement area by Seminole county or utility companies and, further, all
such removals shall be at my/our sole cost and expense.
That this document is binding upon my/our assigns, successors in interest, transferees, heirs,
and all similar ons or entities.
Owner's Signature Owners Printed Name
1101 EAST FIRST STREET SANFORD FL 32771-1468 PHONE (407) 665-7050 FAX (407) 665-7486
Mossy Oak Fence
Limited Power of Attorney
Date: 5134 g
I hereby name and appoint: 6rfs tlQ K an agent of Mossy Oak Fence to be
my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for:
The specific permit and application for work located at:
CV. 5a,-, --d- & 3z-743
License Holder Name: Li'Qnd) 4'lkr
Signature of License Holder:
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this 30 day of "O 20 I? ,
by/qi / teV who is personally known to me or who has
produced identification and who did (did not) take an oath
Signature
C. \'—
jory Seal JANNICE MARIE TORRES
a . Commission # FF 158171ExpiresSeptember9, 2018
Oaid d1Mu Tmy F In iiuuew EOp3AST019
271 Southrldge Industrial Drive
Tavares, FL 32778
407-900-2940
Fax:888-864-2785
4640 North US1
Melbourne, FL 32935
321-255-1020
Fax: 321-255-1036
www.mossyoakfences.com
FOR INTERNAL USE ONLY
DATEINSTALLED:
INSTALLER:
LOCATES#:
LOCATES DATE:
A I& A oe yaG-/k
Mt - ABED BY DATE
SPECIAL INSTRUCTIONS:
NAME Tt I T-- t'.t 't-1 /-CA HOME PHONE
STREET WORK PHONE
CITY ) /&=/ FAX
JOB NAME/ADDRESS
eL [
CELL o' 7 S-
CONTACT EMAIL iPrf A i f000t, A l lo.. :2 , .. I _ -,..A
PVC 3FOOTAGE
HEIGHT
STYLE 01)
COLOR
RAILS i C— X.
POSTS
POST CAPS
PICKETS f esL i
PICKET CAPS
OPTIONS:
WOOD
CYPRESS CEDAR
FOOTAGE
HEIGHT
STYLE
PICKETS
RUNNERS
POSTS
r-ATF ReACTC
ALUMINUM / STEEL
FOOTAGE
HEIGHT
STYLE
COLOR
GRADE
PICKETS
LINE POSTS
TERMINAL P STS
GATE PO S
CHAIN LINK
FOOTAGE
TYPE
HEIGHT
GRADE
TOP RAIL
LINE POSTS_
TERMINALPO
GATE POST _
GATE FIRE!
OPTIONS: OPTIONI
GATES
OTY SIZE PE ARCHED RACKED SWING HINGE
OY <MIN OY ON GAIN OOUT L @(t
OYON Y ON IN OUT OL OR OY
ON Y ON DIN OUT OL OR OYON
Y ON OIN OUT L OR OY ON
I Y ON OUT OL OR OPTIONS: UNDERGROUND
SYSTEMS:
Mossy Oak Fence will perform Iota f r o aAe)thVne,andcable lines.
Purchaser agrees that Mossy Oak Fence will t hqInslblefor damage to anysprinklers, underground pipes, drains, feu flora! other unmarked underground systems.
WOOD PURCHASE NOTICE:
Mossy Oak Fence shall not be liable for any labor or similar sts•or for any costs or
damage which may be associated with the natural characteristics of wood. Wood as have a tendency
to shrink split. warp, crack and twist in hot. humid weather. Small gaps will aD' between boards and
are a common occurrence that does not constitute failure of the wood. RIGHT TO CANCEL
Per Florida and Federal Consumer statutes this contract may be cancelled by either the buyer
or the seller In writing by midnight of the third business day after signing, or by Postmarked no laterthan3businessdaysaftersigning. IMPORTANT INSTALL INFORMATION
FENCE TO FOLLOW
GROUND CONTOUR IK FENCE TO TOP LEVEL REMOVAL & DISPOSAL OF
EXISTING FENCE FT ftM CLEARING OF FENCE
LINE NEEDED YES ® NO CLEARING TO BE
DONE BY OWNER MOSSY OAK FENCE OPEN POOL YES ®
NO HOA APPROVAL REQUIRED
IN YES NO PERMIT REQUIRED Q
YES NO ALL DIMENSIONS AND
SPECIFICATIONS ARE APPROXIMATE L/bl rr' .
011 GI
Xz OPTION • ?/
y ;—
C
OPTION* PROPOSAL AMOUNT: $ " PROPOSAL
AMOUNT: 1(! DISCOUNT: $ /P`
DISCOUNT:
TOTAL: $ TOTAL. DEPOSIT
AMOUNT: S
DEPOSIT AMOUNT: BALANCE DUE , r
Q BALANCE DUE UPON COMPLETION: $ _,[ UPONCOMPLETION- Purchaser agrees that
final price will be CONTRACT AMOUNT: $ determined by totalfootageinstalled, and may be different
than estimated. Purchaser else agrees that
all products dqqVered and DEPOSIT AMOUNT: $ lied remain the
property o ssy Oak Fence 111 lull
payment is mad BALANCE DUE I 1 PON COMPLETION: $ CONTRACTDATEECCEPTE
ASER
BOUNDARY SURVEY '
PROPERTY DESCRIPTION: LOT 127, PLACID WOODS, PHASE TWO, ACCORDING TO THE PLAT THEREOF
AS RECORDED IN PLAT BOOK 58, PAGE(S) 4-6, OF THE PUBLIC RECORDS OF SEMII OLE COUNTY, FLORIDA.
fl11+n
0.
LOT 126
NOT PLATTED
roln+o •
LP. t CAr
r:ooa 40.
a
12" W rOVND YtCA/ PdcM) F:oos
I LOT 127 I 3Z
A/C CONC,^
5. s' v
5' 6r U0
G ti SINGLE FAMILY
RESIDENCE e W LOT 12S
in
R102jtw.
Y
coN ,4 1
CO1/CWALK
10' U.E. I .. ,•o0rtrvi . .
FOUNDP. At CAP S 8916'12" E —D 1 —
1,1, t CAP
e "
00a 40.00' (P$M) j?m
L' CLEASON COVE
50' R/W)
13 27 !
rLANS
L7.. Ok to install approx. linear feet of 6 foot high
privacy/ fence and _L gate(s) as shown on plan. Fence
shail be constructed with finished side facing outward.
WPP
Q SET 1/2• REBAR k CAP PSM / 702
QQ FOUND PROPERTY CORNER
0 FOUND ' X 4' CONCRETE MONUMENT
WELL
CAS METER
CONCRETE FIRE HYDRANT
CENTERLINE
X—X—X—X— BARBED MARE FENCE
I• 30•—0-0-0-0— WOOD FENCE
GRAPHIC SCALE—O—O—O—O— CHAIN LINK FENCE
0 IS 30 OHU OVERHEAD UTILITY LINES
JENNIFER L ALLEN AND WILLIAM J. ALLEN
MARLOWE 3 WEATHERFORD. P.A.
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
THE MONEY SOURCE. INC.
SUNTRUST BANK. N.A.
BEARINGS SHOWN HEREON ARE BASED ON
THE CENTERLINE OF GLEASON COVE
AS BEING S69'16'12"E PER PLAT.
ACCORDING TO THE FLOOD INSURANCE RATt MAP
NO. 12117C 0045 E DATED 04 17 95 THE PROPERTY
SHOWN HEREON APPEARS TO LIE IN ZONE X .
JOB NO. BCA10029 (FIELD DATE:) 07/26/05
LEGEND*
O.R.. OFFICIAL RECORDS
O/B/A - DOING BUSINESS AS
U.E. UTILITY EASEMENT
D.E. DRAINAGE EASEMENT
D.U.E. DRAINAGE do UTILITY EASEMENT
RES. RESIDENCEOU.R. UTILITY ROOM
CONC. CONCRETE
C.B. CONCRETE BLOCK
W.F. - WOOD FRAME
COV. - COVERED
ENT. - ENTRANCE
WM. . WATER METER
WPP . WOW POWER POLE
CPP . CONC. POWER POLE
A/C AIR CONDITIONER
R/W RIGHT OF WAY
I.R.. IRON ROD
I.P. - IRON PIPE
C.M.. CONCRETE MONUMENT
FF ELEV - FINISHED FLOOR ELEVATION
1
IWN BY: RW REVISED: BRADLEY COX & ASSOCIATES
CKED BY: BC LAWOW. SU
STREETDBY: DO TC SANFORD, FLORIDA 32771DPERATINCUNDER
L.B. # 7020 (407) 323-9202
NR - NOT RADIAL
RAD - RADIAL
R . RADIUS
IN - CENTRAL ANGLE
L - ARC LENGTH
CHiBRC. CHORD BEARING
LS. •' LAND SURVEYOR
LB. LAND SURVEYING BUSINESS
F FIELD
M MEASURED
C - CALCULATED
0 DESCRIPTION
P PLAT
PCP . PERMANENT CONTROL POINT
PRM . PERMANENT REFERENCE MONUMENT
PC - POINT OF CURVATURE
IPRC - POINT OF REVERSE CURVATURE
PT . POINT OF TANGENT
POO • POINT OF BEGINNING
iPOC POINT OF COMMENCEMENT
NOTES:
1. THIS SURVEYIIS BASED ON THE LEGAL
DESCRIPTION S. PROVIDED BY THE CLIENT.
2. THIS SUR YOR HAS NOT ABSTRACTED THE
LAND SHOWN EREON FOR EASEMENTS, RIGHTS
OF WAY OR R STRICTIONS OF RECORD WHICH
MAY AFFECT 7}IE TITLE OR USE OF THE LAND.
3. 00 NOT RECONSTRUCT PROPERTY LINES FROM
BUILDING TIES.I 1
4. NO FOOTING OR OVERHANGS HAVE BEEN
LOCATED EXC&7 AS SHOWN.
5. NO IMPROVEMENTS OR UTILITIES HAVE BEEN
LOCATED EXCEPpT AS SHOWN.
6. THIS SURVEif IIS NOT VALID WITHOUT THE
SIGNATURE ANbD THE ORIGINAL RAISED SEAL OF A
1 HEREBY CERTIFY THAT WE HAVE PERFORMED A EIELOSURVEYOFTHEkEREONDESCRIBEDPROPERTY,`THIS
DRAWING IS A RdPkESENTATION OF THAT SURVEY AND
MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH
BY THE FLORIDA BOARD OF PROFESSIONAL LAND SURVtYORS
AND MAPPERS IN CH1L1APTER SIC17-6 FLORIDA ADMINISTRATIVE
CODE PURSUANT TIOISECTION 472.027, FLORIDA STATUTES.
07/28/05
BRADLEY G. COX, PSM #5567 DATE)
THIS INSTRU14ENT PREPARED BY: 3anyl tu- ' OY rS
Name. MOSSY OAK FENCE, LLC
Adaress, 271 SOUTHRIDGE INDUSTRIAL DRIVE
TAVARFC FL 2778
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
11111111111111111 I1111 I1 1 tnii i i
GRANT MALOY SEMINOLE COUNTY
CLERY. OF CIRCUIT COURT & COMPTROLLER
BY. 9148 P9 578 (1P9S)
CLERK'S : 2018064804
RECORDED 06/07/2018 10:45:59 AM
RECORDING FEES $10.00
RECORDED BY hdevore
Permit Number. Parcel ID Number. Z' ' 3v - SZ 3 - U`^O C -- 17,70
The undersignee hereby gives notice that improvement vnll be trace *o certaln real preperty, and .n a=Zt-dance ari:hChatter713, Florida Statutes, the following infornaticn is crovideC in this Notice of Commencement.
0 SCRIPTION OF aMOPERTY: {Legal desai tign of Owppeny an veet address if available)
IoZ o-5212 CV FL, 32773
GENERAL DESCRIPTION OF IMPROVEMENT:
Fee Simple Title Holder (if other than owner) Name:
Address:
CONTRACTOR:
Name: MOSSY OAK FENCE, LLC
Address: 271 SOUTHRIDGE INDUSTRIAL DRIVE TAVARES FL 32778
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be servedasprovidedbySection713.13(1)(b), Florida Statutes.
Name:
Address:
In addition :o himself. Owner Desigrates
To receive a copy 31 the Lienofs Notice as Prodidec in
Se:Uon 713.;30'.gb), Flonda Statutes.
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless adifferentdateisspecified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OINNER AFTER THE EXPIRATION OF THE NOTICE OFCOMMcNCEMENTARECONSIDEREDIMPROFERPAYMENTSUNDERCHAPTER713, PART I. SECTION 713.13, FLORIDA STATUTES. AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOL'R PROPERTY, ANOTICEOFCOMMENCEMENTMISTBERECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENDER CR AN ATTORNEYBEFORECOMMENCINGWORKORRECORDINGYOURNOTICEOFCOMMENCEMENT.
Under penalties o perjury, 1 declare that I have read the foregoing and that the facts stated in it are truethebestofmyt-e and belief.
7• 'm''i Ovnge% 2-rCiC NIL -no
C_nda SLi;;;:o 7t.'3f ;igc - T,o tenor run sign, Div notico ofwn"ricamani and no onoalso MAY oe Demittea tovgn •n *n: w nor veal:
toStateof
Y
County of f-A--110t1q1(
The foregoing instrument was acknowledged bef r tthis%l day of yp
by t t llh I
Who Is personally known to Nameof :ere:n na,r,gc:8cimerC OR
who has produced identification FY{ype of identification produced: msarm
i •,
BEN STALVEY J ., `;
MY COMMISSION II FF 904766 EXPIRES:
Augast 3, 2Ui9 I ofr;„ Fro
f3undtd Thru h'etaryPublic Undr:nxriron 1 it
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