1656 Sea Oats Dr 2013 window 'ice CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
!) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002941 Date 6/28/13
Property Address . . . . . . 1656 SEA OATS DR
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . TO BE UPDATED
Application valuation . . . . 7128
----------------------------------------------------------------------------
Application desc
window replacement
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Owner Contractor
------------------------ ------------------------
ALLAN AND KAREN FROSIO LOWES HOME CENTERS INC
4948 TELSON PLACE
1656 SEA OATS DR ORLANDO FL 32812
ATLANTIC BEACH FL 322335836 (904) 486-4701
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Permit WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee 45 . 00
Issue Date . . . . Valuation . . . . 7128
Expiration Date . . 12/25/13
------------------- --------------------------------------------------------
Special Notes and Comments
NEED NOC
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
-----------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total 45 . 00 45 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 139 . 00 139 . 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
Job Address: owri Peirmit Number:
Legal Description —Z9>£ Stea AA%("# /72�02o -- 02.3n
Fl or Area of Sq.Ft. 'q'Pt
Valuation of Work$ 7/Z� — 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/proposed structure(s) (circle one): Commercial
If an existing structure,is a fire sprinki s stem installed? (Circle one): Yes No N/A
Florida Product Approval # // .0 I-X ,>_ gug g
For multiple products use product approval dorm
Describe in detail the type of work to be performed: -' Gt//�t�otik/
+ O G/100< - --- -- –
Property Owner Information: �'« � S// 44
Name: ���/C7 Address: 1(�neo sz� �`�/ •
City L- StatefG' dip 7�3 Phone
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: A'4 Uwz__Cil/?hCG(' Qualifyin Agent: X - d
Address: City State Zip3Z�lB
Office Phone D - - /'=/ Job Site/Contact Number 3?93Fax#
State Certification/Registration# Sa 64117
Architect Name& Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Addres A11.4-
Bonding
lBonding Company Name and Address
Mortgage Lender Name and Address
Applicatiogkisnotc0, enc,d
hereby made to obtain a permit to do the work and installations as indicated. /certify that no work or installation has commenced prior to the
issuance ermit 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 iwithin six(6)months, or!f construction or work!s suspendedorabandoned fora_penod of sur�6)months at any time after
k iscncd. I nderstand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, urnaces, Boilers, Heaters,
Tanks and Air Conditioners,eta
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.
I hereby certify that 1 have read and examined this,�plication and know the same to be true and correct. All provisioWanddinanoverning this
o1 work will be complied with whether specs ied herein or not. The granting of a permit does not presume tr cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner — Signature of Cont ac or
Print Name ,(�q�-riv......GL4rr Je/OS.tU............................ Print Name _ ......
............
Swo d subscribe efore me Swo to n subscribe before me
th' ay of —20 43 thi
a
DEBRA L CARTER EBRA L CARTER
r��•��~, °
Stme Of
Nota Public Notary Public sy ,:My Comm.Expires Mu 18,2017
CNotary ,�� My Comm.Expires Ma 18,2017 -;?,�,��r' Com iasion# 817�4J��p
i or �� ••.?,a��,,.`• Commission#F EE 87463if �evised l.GV.10
„�����
06/25/2013 16: 33 3524733167 KEYSTONE DOORS & ETC PAGE 01119
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904) 247-5826 Fax(904)247-5845
Job Address: _ Permit Number.•
Legal Description CSS X94 _52Ly9
Valuation of Work$ /2� Proposed Work heated/cooled nota heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)((circle one): Commercial
If an existing structure,is a fire sprinkle system installed?{Circle one): Yes o N/ ;
FILEFlorida Product Approval # l $, COPY For multiple products use product approve orm
Describe in detail the type of work to be performed: 7 Gr1zA&1o�j
+ C�
0 G� _-
Property
Pr a Owner Information:
Name: z Address:
City State ip 3 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Naine: [3s� Qualifyin Agent. _
Address: City State�Zip,,5;
Office Phone Job Site/Contact gli
State Certification/Registration# 6
Architect Name&Phone#
Engineer's Name& Phone# efw-OF ATtMq ITC BEACH'
Fee Simple Title Holder Name and Addres /rl ADDITIONAL
Bonding Company Name and Address NS.
Mortgage sender Name and Address RF.VTPWnn
Application is hereby made ra obtain a permit to do the work and installations as to tca,, , csrlt t at pro io�r"�7c=orTtttlT�ltgtfayl irus enced prior to the
issuance Of a permit and that al!work wrll be performed to meet the standards of all laws regulating constrrtction in this furisdictipn. 7 his permit becomes tial!
and void rf work is not commenced within sis(6)months, or if construction or work is sits ended or abandoned far a period of six(6)months at onv time<fier
work is commenced. 1 understand that separate permits must be secured far Eleclrlcalpwork, Plumbing, Signs, Wells, ,Pools, Furnaces, ,Boilers, Heater,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOVICE 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.
l hereb certify that 1 have read and examined this.arpplication and know the,came to be true and correct. A11 provisioWqLlawandin,�na, overning this
tvpe of work will be complied with whether s ecifzed herein ar not. The granting of u permit does not prestune ta•contel the
provisions of any other federal,slate, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Cont'ac r
Print Name aj-�r v POS iv Print Naine E-
��,......._......_._..........._......._...... ........�._.................. .•......•,...•........
swop d subscribe efore me Swo oa� subscribe before me
th ,ay of !3 thi ± �3
DM L CAA7Lr11 eNA l CMTER
stft
,Notary Public Com, Notary Public Mh C n VW lis.&I»
./t_ r 0 2 r� ,,, Coon WOO 0 EEA 46it tT Cam�t�vi ed U 11L 0
FEB-26-2013 13:24 From:904-247-169 Pa9e:2/7
FIL copy
fJ '1
Pre ares d bund return tn:
Bryan C.Goode, III
Manager
Marsh Landing Title, LLC
320 1 st Street!North Suite 613
Jacksonville beach, F1,32250
904-249-0603
File Number: MLT-13-0039
Will Call No.:
rSpaee Above This Lane For Recording Data]_--...
Warranty Deed
This Warranty Deed made this 1.1th day of June,2013 between Dent C. !Moses,a single woman, individually and as
Truslev(s)orthe The Cart W, Moses and Dent C. Moses Living'rrust whose post Office address is 4600 Middleton.Park
Cir. E„#170,Jacksonville, FL 32224, grantor, and Karin C. Frosio and Allan F. lyrosio, wife and husband whose post
office address is 1656 Sea Oats Drive,Atlantic Reach, PL 32233,grantee:
(Whenever used herein the terms "grantor" and "grantee" include all the p8rtics to (his instrument and the hews, legal rcprcecntativc1, and acsienR of
individuals.and the successnr5 and assigns of corporations.ousts and trustees)
Witnesseth, that said grantor, for and in consideration of the sum of'i'F.N AND N01100 DOLLARS ($10.00) and other
good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged,
has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land,
situate, lying and being in Duval County, Florida to-wit:
Lot 13, Block 13, SELVA MARINA UNIT NO. 6, a subdivision according to the plat thereof
recorded at flat Book,34,Pages 51,51 A and 5111,in the Public Records of Duval County, Florida.
Pat-cel Identification Number: 172020-0230
Together with all the tenements,hereditaments and appurtenances lhcrctu 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 seised 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 whornsnever; and that said land is free of all
encumbrances,except taxes accruing subsequent to I)ceember 31,2012.
Double7ime•
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..vtar.:wva•:,,....+,:.�.ax.,>v,..v+,sr.w.un.,a.y;p:
In 'Witness Whereof,grantor has hereunto scat grantor's hand and seal the day and year first above written.
Signed,sealed and delivered in our presence:
Wim ane: i b an 0O 2, Dent C.Moses,individually and as Trustee
W it ess Name: />4,ma
State of Florida
County of Duval
The foregoing instrument was acknowledged before me this 1 1 th day of June, 2013 by Dent C.Moses,who is personally
known or[X] has produced a driver's license as identification.
[Notary Seal] Notary A lie
tcd Name:
rlll�lfldE1
L. SMITH
COMRS5ION 4 DD9ABt*Commission Expires:
EXP*?ES De rember 15,1013
(40 3413-0�51 FbrKiaNMP GMipl.a�m
Warranty Deed•Pop 2 DoubtsTlma►
FEB-26-2013 13:24 Fro :904-247-169 Pa9e:4, 7
HUD-1 OMB Approval No. 2502-0265
A. Se, .,,ment Statement HUD-1)
B. Type of Loan
1 FHA 0 2. RKS 0 3.Conv.Unins. 6.File Number 7.Loan Number a_ Mortg.Ins,Case Num.
MLT-13.0039 0899078213 091-5505279703
{� 4 VA 0 5 Conv. Ins. ID:
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 the closing;they are shown here for informational purposes and are not included in the totals.
0.NAME OF BORROWER: Karin C. Froslo and Allan E.Frosio,wife and husband
Address of Borrower: 1656 Sea Oats Drive,Atlantic Beach,Florida$2233
E.NAME OF SELLER: Dent C.Moses as Trustees)of the The Carl W.Moses and Dent C Moses Liviflg°'bust'°
Address of Seller: 4600 Middleton Park Cir. E.,#B70,Jacksonville, Florida 32224
5
to t
F, NAME OF LENDER: Regions Bank dlbla Regions Mortgage :' FILE COPY
Address of Lender: 2050 Parkway Office Circle, Birmingham,Alabama 35244
G.PROPERTY LOCATION: 1656 Sea Oats Drive,Atlantic Beach, Florida 32233 z�
+1PG>Y MT►4lN�fAi.�Y.4
H.SETTLEMENT AGENT: Mash Landing Title, LLC
Address, 320 1st Street North,Suite 613,Jacksonville Beach, Florida 32250 Phone'904-249.0603
Place or Settlement: 320 1st Street North, Suite 613,Jacksonville Beach, Florida 32250
I. SETTLEMENT DATE: 6/11113 DISBURSEMENT DATE: 6111113
J.Summary of borrower's transaction - K.Summary of seller's_transaction
100.Gro-"amount due from borrower: 400-Grog9 amount due to seller:
101.Contract sales price 301,000.00 401.Contract sales price 301,004 00
102.Personal property 402. Personal property
103.Settlement charges to borrower(Line 1400) 11,809.05 403.
104 404.
105. 405.
Adjustments for items paid by seller in advance: Ad ustmants for{toms old by_setler en advanoe:
106 City/town taxes 406.City/town taxes
107.County taxes 407. County taxes
108 Assessments 408.Assessments
109 409.
11U. 410
111 411.
112. 412.
120.Gross amount due from borrower: 312,80905 420.Gross amount duo to seller: 301,000 00
200_Amounts old or in behalf of borrower: $00,Reductions in amount due to seller:
201 Deposit or earnest money 5,000.00 501.Excass deposit(see instructions)
202.Principal amount of new loans) 295,548.00 502.Settlement charges to seller(line 1400) 21.059.50
203.Existing loan(s)taken subject to 503.Existing loans)taken subject to
204 Principal amount of second mortgage 504. Payoff of first mortgage loan
205. 505. Payoff of second mortgage loan
206. 506.
207 507.
208.Principal amt of mortgage held by seller 508. Principal amt of mortgage hold by seller
209. 549
209". 509a
Ad I usim_o_nts for Items un ald by seller: ___ Ad ustments for item un aid eller:
210. City/town taxes 510 Cityltown taxes
211.County taxes from 01/01/13 to 06/11/13 726.87 511. County taxes from 01/01/13 to 06/11/13 726.87
212.A6sessments 512.Assessments
213 513
214 514.
215.Owners tltle policy credit per contract 1.580.00 515. Owners title policy credit per contract 1,580 DO
216.Deed Stamp credit par contract 2,107.00 516.Deed Stamp credit per contract 2,10700
217 l itle search credit per contract 10u.00 517- t IUs saarcn credit per contract 100.00
74.00
218 Tax Service Fee credit per contract 7400 518 Tax SeMce Fee credit per contract
219. 519.
30
220.Total paid bylfor borrower: 5,135.87 520-Total reductions in amount due seller: 25,647.37,
300.Cash at settlement fromlto borrower: 600_Ca hat settlement tolfrpm Seller:
301.Gross amount due from borrower (line 120) 312,80905 601.Gross amount due to seller (lints 420) 301,000.00;
JU2 Less amount paid by/for the borrower (lino 220) (305,135.87) 602.Less total reductions in amount due seller (line 520) (25,647.37)
303.Cash( L From [J To )Borrower: 7,1373 1R 603. Cash( U To LI From )Seller. 275,352.63
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 coverad transaction with information during the
settlement process.
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FEB-26-2013 13:25 From:904-247-169 Pa9e:5.17
HUD-1 U.S.Department of Housing and Urban Develo it Page 2
L. Settle-nentcharges
Paid from Paid from
700,Total Real Estate Brokor Foos $16,- -00
Borrowers Seller's
Division of commission(line 700)as follows: _ s,,.,;, r y: - Funds at Funds at
701. $7,525.00 to RErMax Unlimited settlemont Settlement
702 $9,03000 to Watson Realty Corp.
703. Commission paid at settlement i t i 16,555.OD
704. "'
a" 0W WWII
tQ
705 .,.. -
800 Items Payable in Connection with Loan
801. Our origination charge $3,854.65 (from GFE 91)
802 Your credit or charge(points)for the specific interest rate chosen ($6,564.15) (from GFE#2)
803. Your adjusted origination charges to Regions Bank d/b/a Regions Mortgage (from GFE A) -2,709.50
804. Appraisal fee to Andrew J. Ebert (from GFE#3) 425.00 POC(B)'
805. Credit report to Equifax Mortgage Solutions (from GFE#3) 18.00
806. Tax sdrvrce to 1st American Tax Service (from GFE#3) 74.00
807. Flood certification to Corelogic from GFE#3 7.50
808. Final Inspection to Andrew J. Ebert 100.00
800. to
810. to
811. t0
812 to
813. to
Items by-Lender to BePaid in Advance
901. daily interest charges from 06/11113 to 07/03/13 28.3400 Ida (from GFE#10) 566.80
902 Mortgage Insurance premium for 360 months to Dept. of HUP trom GFE#3 5,083.14
.
903. Homeowners insurance premium years to Sunshine State Insurance (from GFE#11) 1,85125
904 Flood insurance premium for yearsto
1905. ears to
1000-Ess: OD r
1001 Initial deposit for your escrow account from GFE 09 1,064.66
1002. Homeowner's insurance 3 months $154.28 per month $462 84
1003 Mortgage insurance months $303.85 er month --..
1004 Property taxes 10 months A $137-33 permonth $1,373.30
1005 Flood insurance months 0 per month
1006. months a per month
1007. months Q pF-r month
1006. months 0. per month
1009 Aggregate accounting adjustment ($771.18)
11 0 Title Charges
1101.Title services and lender's title insurance from GFE#4) 335.50
1102. Setticmont or closing fna to Marsh Landing Title, LLC 425.00
1103 Owner's title insurance to Old Republic Nat.Tilla)Marsh Landing (from GFE#5) 1,580.00
OF6.1580 00
1104 Lender's title insurance to Old Republic Nat.Title)Marsh Landing $235.50
MF6-25.00,5.1-25;8.1-25,F9.3-160-50
1105. Lender's title policy limit$29.53,348.00
1106. Owner's title policy limit$301,000.00
1107. Agent's portion of the total title insurance premium$1,270.85 to Marsh Landing Title, LLC
1108. Underwriter's portion of the total title insurance premium$544.65 to Old Republic National Title Insurance Comp
1109. Abstract or title search to Old Republic National Title In!$100.00
1110 to
1111. to.
1112. to
1113 to
1200.Government R c rding ands-- - 105.00
1201 Govornmonl recordingcharges (from GFE#7
1202. Deed 18.50 Mart a e s 86.50 Releases$0.00 $105 00
1203.Transfer taxes (from GFE#8) 3,732.70
1204 City/County taxlstamps Deed $0.00 Mortgage(s) $591.10
1705 State tax stamps Deed $2,107 00 Mortgages) $1,034.60 1850
1206. Record Trust.Affidavit to Clark of Court
1207 Record Term.of NDC
to Clerk of Court
61.00
1208,
1 di l
1301. Required Services that you can shop for -from GFE#6
to Durden Surveying and Mappin 300001
1302 Survey •200.00
1303. Butler Rebate to Marsh Landing Title,LLC
1304. Repairs
to Lockhart Construction and Roc 3,900.00
1305 to
1306. to
1307 to
1348 to
1309.
1400.Total Settlement Cha es 11.809.05 21,059.50
(Enter on lines 103,Section J and 502,Section K)
* POC(B) =Paid outside of closing by borrower
**The exception rate option was used In this file
*POC(S)-Paid outside of closing by seller
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FEB-26-2013 13:25 From:904-247-169 Pa9e:6,7
SETTL,.AENT CHARGES AND LOAN TERMS
rage 3
Settlement Charges
Charges That Cannoticeas11 ''_ UD11i.W +'
Our origination charge #801 $3,854.65 $3,854 85
Your credit or charge(points)for the specific interest rate chosen #802 $-6.564.15 $x,564.15
Your adjusted origination charges #803 $-2,709.50 $ 2,709.50
Transfer taxes # 1203 $3,733.00 $3,732.70
Charges That in Total Cannot,.lgcre
Government recording charges #1201 $225.00 $105.00
Appraisal fee #804 $425.00 $425.00
#805 $19.00 $18.00
Credit report
Tax�carltifiCabOr'
#806 $74.00 $74001
Flo #807 $7 50 $7 50
Final Inspection #808 $.00 $100.00
Mortgage insurance premium for #902 $5,083.14 $5,083.14
_ � - �;z.; ':.1v;f;)•,>:;,x;:.;rtG"�j',. '�:'t.?h ti';'�1''•;' ��e a''y, .�' Tofdl'. $5,832.6a $5,812.64
�:�.. _ :+°_b�a.e:',:.y}'«.:v:�:t u:il�=.s�sd�,a,•� e:fl,,}lk�i� t >� ..,G,�1• �:, ..
_ ..{� ..- ;-a.:::w• � � $-20.00 or 0.00%
.;.rMY ..r, ,•t' .p"''" U"�.a';:��',�Cr,'QiSR,�tiVY@@Il,lr7��i�t1'�'11.� �It .� ,�.,
� '' 1'; � }i 'ly 1 •. t
ChargesThafCarrChanga 1,. ;:w,,�;��.;�.. j�,r�. �:,,i;4;.�,'��r�;. -�.�:r�;M: :�:rl' -w•, !� �t;;.
Initial deposit for your escrow account
#1001 $769.28 $1,064.66
Daily interest charges from #901 $566.80 $566.80
903 $1,320.00 $1,851.25
Homeowner's insurance premium for
#
#1101 $858.00 $335.50
Title services and lender's title insurance
Owner's title Insurance #1103 $1,580.00 $1,580.00
Loan Terms
Your initial loan amount is $295,548 00
Your loan term Is 30.0000 years
Your initial interest rate is 3.5-%
Your initial monthly amount owed for principal,interest, $ 1,630.97 includes
ana any mortgage insurance is Pr principal P Interest W Mortgage Insurance
Can your interest rate rise? No (� Yes ,it can rise to a maximum of 00"/o.The first change will be
on and can change again every after
Every change date,your interest rate can increase or decrease
by .00%.Over the life of the loan,your interest rate is guaranteed to never be
lower than 00%+or higher than 00%
Even it you make payments on rima,can your loan No (� Yes ,it can rise to a maximum of$.00
balance rise?
Evon it you make payments on time,can your monthly No O Yes ,the first Increase can be on and the monthly amount
amount owed for principal,interest,and mortgage owed can rise to$ .00
insurance rise? The maximum it can ever rise to is$.00
Does your loan have a prepayment penalty? 0 No Yos ,your maximum prepayment penalty is$.00
Goes Your loan have a balloon payment.
No Yes ,you have a balloon payment of$ .00 due in
years on 0010010000
Total monthly amount owed including escrow You do not have a monthly escrow payment for items, such as property
account payments taxes and homeowner's insurance You must pay these items directly yourself.
• You have an additional monthly escrow payment of$ 291.61
that results in a total initial monthly amount owed of$ 1,922.58 This includes
principal,interest, any mortgage ins-trance and any items checked below-
Pr Property taxes Homeowner's insurance
Flood insurance r
Note, If you have any questions about the Settlement Charges and Loan terms listed on this form,please contact your lender.
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FEB-26-2013 13:25 From:904-247-169 Paee:7,7
HUD-1 St f TLEMENT STATEMENT s
FILE
Filo Number: MLT-13.0039 R
I 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 the HUD-1 Settlement Statement.
Borrower(s)
AL
Karin C_ rosin E. krosao
Seller(s)
��.
xza `
Dent C. Moses
Trustee
Settlement Agent
The MUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have
caused or will cause the funds to be disbursed in accordance with this statement.
Marsh Landiirn Title, LLC
Date:
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.
DoubloTimo@
�yLvr,e4 City of Atlantic Beach APPLICATION NUMBER
:,.
Building Department (To be assigned by the Building Department.)
Y S 800 Seminole Road 13 ' /L J
X Atlantic Beach, Florida 32233-5445 '"'�� ll "1
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Dg9artLnent review required Ye No
Building
Applicant: L anning &Zoning
Tree Administrator
Project: A)lAIA40) Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. []Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: / Date:_64 ",_::�6
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
07/16/2613 13:46 3524733167 KEYSTONE DOORS & ETC PAGE 01101
uoCff20131821 4, OR SK 16452 Page 395, Number Pag": 1, Recorded 07/15/2013
at 08:35 AM, R nniA Fussall CLERK CZRCUXT COURT DUVAL COUNTY RECORDING $10.00
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