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Permit Roof 730 Bonita 2011 PY N ,.. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 `` r� `� Application Number 11- 00002492 Date 8/15/11 Property Address 730 BONITA RD Application type description ROOF PERMIT Property Zoning TO BE UPDATED Application valuation . . . 5100 Application desc Reroof Owner Contractor HELMLY KATHERINE C BRANNEN ROOFING, LLC 730 BONITA ROAD 1024 PEBBLE RIDGE DRIVE ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32220 (904) 813 -4967 Permit ROOF PERMIT Additional desc . REROOF Permit Fee . . . 80.00 Plan Check Fee .00 Issue Date Valuation . . . . 5100 Expiration Date . . 2/11/12 Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 80.00 80.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 84.00 84.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 (� 1 Job Address: '30 60i\ii-A Permit Number: 7/ 24/ --7 Legal Description Parcel # Valuation of Work $ 6 100." Proposed Area of Sq.Ft. Sq.Ft Proposed Work heated /cooled non - heated /cooled Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window /door Use of existing /pro osed structure(s) (circle one): Commercial Residentia If an existing structure, is a fire sprinkler system installed? (Circle one es No N /A Florida Product Approval # fir-- t o t ?—` f . I For multiple products use product approval form `� Describe in detail the type of work to be performed: ( 41404 (144$ - k i{'1 A « u rh (_ 5 A i A (e j' Property Owner QQ Information: Name: YA heir1r1C C He]n� Address: 1 3t7 Uani +a City q-OAL44 L kilt h State FC.Zip 3 Z/7.-3 3 Phone ° t'D'-/- - 7133 • 3(0 E -Mail or Fax # (Optional) Contractor Informmation: �` Company Name: f`7 'l 1(),{crnl kt)'f l �1�j U C Qualifying Agent: ' qO IJI ((f 6 st,�( Address: 1f) 2 / c f . (�eob It Pack r City TAY Sta i%L- Zip 3 Z4-2-' Office Phone q D(f- ( 3 `4-( %'7 f Job Site/ Contact Number ti- 91 - if % Fax # 781-e( •� State Certification/Registration # CCC 1 9 b b la Architect Name & Phone # Engineer's Name & Phone # Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time a /ier work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Healers, Tanks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 hereby certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, state, or local law regulating construction or the performance of construction. i �l. Signature of Owner V v Signature of Cont for '' Print Name , , .e u n t. Q .€� Print N ame 1 i ii . , a06, Sworn to and subsc ibed before me Fir ` _. DEBORAH AMANDA WHITE _ Sworit#444 subscrib mMY •• ,' this 6i,(- Day of � , 20 � ( this Day of . niay21,2o X20 /I 1 �d>IlDlliii� AI I e . ter!♦ I' No a "ub�ic Notary Public , .:g ; MIRANDA T. SKELTON M�"' /, Revised 01.26.10 `� r im :. Commission # DD 986198 Z S 7 J 4 3 � Expires April 27, 2014 '' ; •7.:th `' Bonded TMU Troy Fain Insurance 800- 385-7019 Doc g 20 ;1177o, 4 UR SK 13666 Rage .4:- Number Pages: 1 Recorded 08 15 2011 at 09:36 AM JIM PULLER CLERK CIRCU■T COURT DUVA COUNTY RECORDING $10 00 - NOTICE OF COMMENCMENT State of Florida PERBMIF 6e „ Ti e r gdersigaed herby Worsts all concerned that haproveasods mall be node to certnit real property, and in aearrdanee midi seethes 713.13 et the Flowida Statses, do fellowirg information is stated m the NOTICE OF COMMNCMENT. Description of property . _ . 1 5. 6 i...-1 a i i' . C i) _ 1 • — Geseral description of iumprovonent _BMW - Owner - K6MI.Z.virk , el Irv\ 11 . Address 1?, 6 i i...c. Owner's interest in site of the iniprarent SOME F�'9 Tide holder Walther than owner) Nam SAME Address SAME Contractor DRANPIAPI ROOFING LLC Address 1.7.41,21181.1CREDIGNIPRIVEJACKIM Surety Cif any) NONE _Address NIA Anseseet of Bond SIVA - -- Name of person within the State of Florida designated by owner rpm whom norm or other doormats may he serve& I/ 1 1 t,z).-riv_iloc let vv-Nlii -- - .., - Phone ......- r - Address 1 3 C nc,,, I r In adoration to binthersel4 owner designates the foilinting poem to receive a ow of 011C Lerair"s Nader us provided ha Section' a 713.13(1) (P), Florida Stalintes. (Fill in at Oweees option). Name SAMS Address SAME TEM SPACE 18 FOR RECORM/rS USE ONLY My Commission limping: \<aAheri,44) C kii OVIRSOCIS IPRIPITEDNAlte I lia . -t. • V Signature M e s,:gulli c, IRANDA T. SKELTON - - ........... T)t..,4 44r a 1 , , _ • _ ctx1 0 4: i Commission # DD 986198 Expires April 27, 2014 *KW Bonded Thru Troy Rim Insurance 800-385-7019 ------------------ 08/15/2011 MON 9:15 FAX 2002/005 Sales Price: $96,000.00 This Warranty Deed Made this 12th day of August,2011 A.D. by Larrry Randall Schrecengost AND Sharon Bradley Schrecengost, his wfe hereinafter called the grantor, to Katherine C. Helmly whose post office address is: 6321 Raw Hyde Trail North, Jacksonville, FL 32210 hereinafter called the grantee: (Whenever used herein the term "grantor" and "grantee" include all the parties to this instrument and the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations) Witnesseth, that the grantor, for and in consideration of the sum of $10.00 and other valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the grantee, all that certain land situate in Duval County, Florida, viz: Lot 4, Block 1, Royal Palm Unit 1, a subdivision according to the plat thereof recorded at Plat Book 30, Pages 60 and 60A, in the Public Records of Duval County, Florida. SUBJECT TO all covenants, conditions, restrictions, reservations, limitations, easements and to all applicable zoning ordinances and restrictions and prohibitions, the reference to which shall not operate to reimpose same, imposed by governmental authorities, if any, and taxes for the current year. Parcel Identification Number: 171094 -0000 Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. To Have and to Hold, the same in fee simple forever. And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances except taxes accruing subsequent to December 31, 2010 In Witness Whereof, the said grantor has signed and sealed these presents the day and year first above written. Signed, se:l crnd..deiivvered in our presence: ..HO'!AS . SANTORO -Witness m r Larrry Randall Schrecengost - seller rry Schrecengost ;i Lauri Maynor - Witness Sharon Bradley Schrecengost -' "4ou« 1719 Aston Hall Drive East, Jacksonville, FL 32246 State of Florida County of Clay The foregoing instrument was acknowledged before me this 12th day of August, 2011, by Larrry Randall Schrecengost AND Sharon Bradley Schrecengost, his wfe who is personally known top o y/v has produced a drivers license as identification. ' ' ' THOMAS C. SANTORO ' PREPARED BY Trina M. Larsen �: :R` Commission # 918993 ' Notar Expires October 3 1, 2013 Public _� � =w' 3 RECORD & RETURN TO: z ; ionamo t,. -” Troy Fain tnwan imonai inin Print Name: Thomas C. Santoro Thomas C. Santoro My Commission Expires: `- 1700 Wells Road Suite 5 Orange Park, Florida 32073 (904) 278 -8713 File No: 11 -17126 08/15/2011 MON 9:15 FAX 0001/005 Thomas C. Santoro 1700 Wells Road, Suite 5 Orange Park, Florida 32073 (904) 278-8713 Phone (904) 278-8768 Fax ..„ . TO: ; From: Trina Larsen trinaAsantoro-law.eom c; • • ) ; 14; ; A ( A•-• . . ,„ t ,•T) ;:• 1` <Li.) 08/15/2011 MON 9:15 FAX 12003/005 1 OMB Approval No. 2502 -0265 ; ' A. Settlement Statement (HUD -1) B. Type of Loan __..__...-.----.--_-_-.-.- r--- i 6. File Number: 7. Loan Number; 1 B. Mortgage Insurance Case Number t_ [ FHA 2.,r. RHS 3 CONY. UNINS. • • 1 11 -17126 4, f VA 5. j CONV. INS. • • C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside 1 the closing; they are shown here for informational purposes and_ are_ not included in the totals. -� I D. Name & Address of Borrower: 1 E. Name & Address of Seller: F. Name & Address of Lender: Katherine C. Helmly 1 Larrry Randall Schrecengost and Sharon Larry Randall Schrecengost and Sharon 16321 Raw Hyde Trail North Bradley Schrecengost Bradley Jacksonville, FL 32210 i 1719 Aston Hall Drive East i Jacksonville, FL 32246 G. Property Location: I H. Settlement Agent: I. Settlement Date: 730 Bonita Road ;Thomas C. Santoro, Esq. August 12, 2011 Atlantic Beach, Florida 32233 i 1700 Wells Road, Suite 5 Duval County, Florida Orange Park, Florida 32073 904- 278 -8713 fax: 904 - 278 -8768 j Place of Settlement: 1 Thomas C. Santoro, Esq. 1 1700 Wells Road, Suite 5 { Orange Park, Florida 32073 I Phone: (904) 278 -8713 J. Summary of Borrower's Transaction [K. Summary of Seller's Transaction 100. Gross Amount Due From Borrower: 1 400. Gross Amount Due To Seller: - -_ _ 101. Contract Sales Price 96,000.00 401. Contract Sales Price 102. Personal Property 402. Personal Property 103. Settlement Charges to Borrower (line 1400) 3,047.00 403. ___ Adjustments for Items Paid by Seller in Advance: Adjustments for Items Paid by _Seller in Advance: 106. City / Town Taxes 406. City_! Town Taxes 107. County! Parish Taxes 407. County/ Parish Taxes 108. Assessments 408. Assessments 120. Gross Amount Due from Borrower: - 99,047.00 420. Gross Amount Due to Seller: 96,000.00 200. Amounts Paid by or in Behalf ofBorrower: 1 500. Reductions in Amount Due to Seller: __ 201. Depositor Earnest Money _ 501. Excess Deposit (see instructions) 202. Principal Amount of New Loan _ 96,000.00 502. Settlement Charges to Seller (Line 1400) �_ 0.00 203. Existing Loan(s) taken subject to _ • 503. Existin. Loanjs) taken subject to .- .__ - _.____.__... 204. Daily interest credit _..__ 504. Payoff of First Mortgage Loan 205. -_.._ 505. Payoff of Second Mortgage Loan 206. x_506. Purchase Money Mortgage __- ______• -_ 207. i 507. Seller Financing 96,000.00 _____..�... - __ - -.- Adjustments for Items Unpaid by Adjustments for Items Unpaid by Seller: 210. City / Town Taxes 510. City I Town Taxes 211 County / Parish Taxes Jan 1, 2011 thru Aug 11, 1,459.79 511, County ! Parish Taxes Jan 1, 2011 thru Aug 11, 1,459.79 2011 2011 - 212. Assessments 512. Assessments 220. - Total Paid by / for Borrower: - T 97,459.79 _ 520. Total Reductions in Amount Due Seller: 97,459.79 -- - -- 300. Cash at Settlement from / to Borrower: 600. Cash at Settlement to / from Seller: 301. Gross Amount due from Borrower (line 120) 99,047.00 i 601. Gross Amount due to Seller (line 420) 96,000.00 302. Less Amount Paid by /for Borrower tie 220) 97,459.79 ? 602. Less Reductions Amount due Seller (line 520) 97,459.79 303. Cash From Borrower: $1,587.21 603. Cash From Seller: $1,459.79 , The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting, reviewing, and reporting the data. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. No confidentiality is assured; this disclosure is mandatory. This is designed to provide the parties to a RESPA covered transaction with information during the settlement process. Previous editions are obsolete ....... Page 1 of 3 _ - - HUD -1 August 11, 2011 11:47 AM 08/15/2011 MON 9: 16 FAX 1004 /005 Settlement Date: August 12, 2011 File Number: 11 -17126 L. Settlement Charges ; f - Paid Paid from Paid from 700. Total Sales / Broker's Commission: I Borrower's i Seller's Division of Commission (line 700jas follows f Funds at i Funds at 701. Settlement ' Settlement 702. 703. Commission Paid at Settlement 800. Items Payable in Connection with Loan: _ W - - - -- 801. Our origination charge (from GFE #1 -� - $0.00 802. Your credit or charge (points) for the specific interest rate chosen (from GFE #2) I $0.00 803. Your adjusted origination charges (from GFE #A 804. Appraisal Fee 805. Credit Report I 1 806. Tax Service _ j 807. Flood Certification - -- j 900. Items Required by Lender to be Paid in Advance: r -- --- 901. Daily interest - NONE (from GFE #10) 902. Mortgage Insurance Premium _ - (from GFE #3) 903. Homeowner's Insurance (from GFE #11) I i _ 1000. Reserves Deposited with Lender _ __ 1001. Initial deposit for your escrow account _ (from GFE #9) I - 1002. Homeowner's Insurance I i ___._.___.__ _ . 1003. Mortgage Insurance .' i 1004. Property Taxes 1100. Title Charges: . - 1 - 1 - - 1101. Title services and lender's title insurance - (from GFE #4) I 1,050.00 - Closing Fee to Thomas C. Santoro, Esq. $375.00 j - Title Search to Old Republic National Title Insurance Company $100.00 - Simultaneous Issue to Thomas C. Santoro, Esq. $150.00 I - Attorney Fee to Thomas C. Santoro, Esq. $200.00 - Document Preparation Fee to Thomas C. Santoro, Esq. - -_ $200.00 1102. _Settlement or Closing,f, _.^ $ I_..___.___..__._..____.__.. 1103. Owner's Title Insurance (Old Republic National Title Insurance Company) (from GFE #5) 1 (Risk Rate Premium: $552.00)_ - _ 745.00 I 1104, Lender's Title Insurance (Old Republic National Title Insurance Company) to Thomas C. Santoro, Esq. - Lender's Premium $25.00 1105. Lender's Title Policy Limit $96,000.00 I 1 1106. Owner's Title Policy Limit $96,000.00 1107. Agents Portion of the Total Title Insurance Premium $539.00 i 1108. Underwriter's Portion of the Total Title Insurance Premium $231.00 1200. Government Recording and Transfer Charges: ( -_ 1201. Government Recording Charges from GFE #7) 52.00 1202. Deed $17.50 Mortgage $34.50 Releases $0.00 1203. Transfer Taxes (from GFE #8)T 1,200.00 1204. City /County tax/stamps Deed $0.00 Mortgage $0.00 _ - _ __ 1205. State tax/stamps -_ Deed $672.00 _ Mortgage $336.00 1206. Intangible Tax to Simplifile _. -___-_ $192,00 _ 1207. Other Tax 2 1 r----•.---- -- -___ 1300. Additional Settlement Charges: _ 1301. Required services that you can shop for _� �_ (from GFE #61_, 1 1400. Total Settlement Charges (Enter on line 103, Section J and line 502, Section K) $3,047.00 $0.00 1 have carefully reviewed the HUD -1 Settlement Statement, and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of HUD -1 Settlement Statement. i ,: i - t �� f . Borrower: _ _ - ,: - - Seller: -- -- - --r- Katherine C. Helmly Larrry Randall ' S chrecengost Sharon Bradley Schrecengost The HUD -1 Settlement Statemetch -,6 -h'Sve prepared is a true and accurate account of this transaction. f have caused or will cause the funds to be disbursed in accordance with s ateinent. Settlement Agent: _,:-"Y.---;" Date: August 12, 2011 THOMIAS NTORO WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprisonment. For details see Title 18 U.S. Code Section 1001 and Section 1010. Previous editions are obsolete Page 2 of 3 HUD -1 August 11, 2011 11:47 AM 08/15/2011 14014 9:16 FAX 0005 /005 Settlement Date: August 12, 2011 File Number: 11 -17126 Compaason of Good Faith Estimate (GFE) and HUD Charges Good Faith Charges That Cannot Increase I 1 HUD Line No. Estimate HUD Our origination charge # 801 _ — 0_00 i 000 Your credit or charge (points) for the specific interest rate chosen # 802 0.00 ( 0.00 Your adjusted origination charges # 803_ _. -.. 0.00 _ _ 0.00 Transfer taxes — .__•.____..,_______ #1203 1 0.00 I 1.200.00 Good Faith i " ..- �`__ Charges That in Total Cannot Increase More Than 10% HUD Line No. HUD Estimate j __ Government Charges #1201 I 0.00 52.00 .. Total i ...._._.. - 52.00 Increase between GFE and HUD Charges 52.00 100.00% Good Faith Charges That Can Change HUD Line No. —�- , HUD Estimate _ Initial deposit for your escrow account #1001 I 0.00 i 0.00 Daily interest - NONE ! # 901 I 0.00 0.00 Loan Terms Your initial loan amount is 11'96,000.00 Your loan term is 30 years ' i Your initial interest rate is 1 4.5 % Your initial monthly amount owed for principal, interest, and } $486.42 includes I any mortgage insurance is I [ X ] Principal ' [ X] Interest [ 1 Mortgage Insurance _, Can your interest rate rise? [ X ] No. [ ] Yes, it can rise to a maximum of %. The first change will be on and can change again every after . Every I change date, your interest rate can increase or decrease by %. Over the life of 1 the loan, your interest rate is guaranteed to never be LOWER than % or HIGHER than %. Even if you make payments on time, can your loan balance j [ X ] No. [ 1 Yes, it can rise to a maximum of $ . rise? Even if you make payments on time, can your monthly ; [ X ] No. [ 1 Yes, the first increase can be on and the monthly amount amount owed for principal, interest, and mortgage I owed cart rise to $ . insurance rise? I The maximum it can ever rise to is $ . 1 Doesyour loan have a prepayment penalty? [ X ] No [ ] Yes, your maximum pre ment penalty is $ _ Does your loan have a balloon payment? [ X ] No. [ ] Yes, you have a balloon payment of $ due in years on Total monthly amount owed including escrow account [ X ] You do not have a monthly escrow payment for items, such as property taxes payments and homeowner's insurance. You must pay these items directly yourself. [ ] You have an additional monthly escrow payment of $ that results in a total initial monthly amount owed of $ . This includes principal, interest, any mortgage insurance and any items checked below: [ ] Property taxes [ ] [ ] Flood insurance ( 1 Homeowner's insurance ( 1 l Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact your lender. Previous editions are obsolete -- Page 3 of 3 ��� — _ HUD -1 August 11, 2011 11:47 AM 08/15/2011 MON 9:48 FAX 0002 /002 Recorded Electronically OR BK X.s „5 /6 w. Rage(s) .....1e--- .. Sales Price: 496,000.00 " County, Florida Date: &/!/2 rs / , Time: /'% 6 7l- : f This Warranty Deed Made this 12th day of August,2011 A.D. by Larrry Randall Schrecengost AND Sharon Bradley Schrecengost, his wfe hereinafter called the grantor, to Katherine C. Helmly , A Single Woman whose post office address is: hick ikmk lixkogiliamaiHt kX 22)W 730 Bonita Road, Atlantic Beach, Fi. hereinafter called the grantee: 32233 (Whenever used herein the term "grantor” and "grantee" include all the parties to this instrument and the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations) Witnesseth, that the grantor, for and in consideration of the sum of $10.00 and other valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the grantee, all that certain land situate in Duval County, Florida, viz: Lot 4, Block 1, Royal Palm Unit 1, a subdivision according to the plat thereof recorded at Plat Book 30, Pages 60 and 60A, in the Public Records of Duval County, Florida. SUBJECT TO all covenants, conditions, restrictions, reservations, limitations, easements and to all applicable zoning ordinances and restrictions and prohibitions, the reference to which shall not operate to reimpose same, imposed by governmental authorities, if any, and taxes for the current year. Parcel Identification Number: 171094 -0000 Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. To Have and to Hold, the same in fee simple forever. And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances except taxes accruing subsequent to December 31, 2010 • In Witness Whereof, the said grantor has signed and sealed these presents the day and year first above written. / ' Signed, eiileq�,ancj..cIelivered in our presence: r 4.—' --- THOMAS C. SANTORO . Randall Schrecengost senor - Witness e � ' / mil ; �: , . t t ' " ._. Laura Maynor - witness Sharon Bradley Schrecengost)' - -Seller 1719 Aston Hall Drive East, Jacksonville, FL 32246 State of Florida County of Clay The foregoing instrument was acknowledged before me this 12th day of August, 2011, by Larry Randall Schrecengost AND Sharon Bradley Schrecengost, his wfe who is personally known to , e o .who has produced a drivers license as identification. aawyi..aomw,. ,,: , „0: , ,,, THOMAS C. SANTORO r' ,/ I �' _ _ PREPARED BY Trina M. Larsen : *= Commission # r 3 , 201 3 Notary public W • ?; ,• . �: Expires October 31, 2013 Y '' ,, " a r V. 9oreok Tin Troy F Insurance $0°-38$.7014 RECORD & RETURN TO: ,,,,,,,,�, Print Name; Thomas C. Santoro Thomas C. Santoro My Commission Expires: 1700 Wells Road Suite 5 Orange Park, Florida 32073 (904) 278-8713 File No: 11 -17126