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1665 Beach Ave 2014 Foundation repiar S CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �Jjilt RESIDENTIAL ALT/OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 14-00001365 Job Type: RESIDENTIAL OTHER Description: foundation repair Estimated Value: $10,300.00 Issue Date: 12/9/2014 Expiration Date: 6/7/2015 PROPERTY ADDRESS: Address: 1665 BEACH AVE RE Number: 169657-0000 PROPERTY OWNER: Name: OCEAN GROVE PARTNERS LLP Address: GENERAL CONTRACTOR INFORMATION: Name: HYGEMA HOUSE MOVERS, INC Address: PO BOX 2655 QA RICHARD MARK BOYLES Phone: - - PERMIT INFORMATION: BUILDING DEPARTMENT: 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. FEES: PERMIT FEES $105.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 PLAN CHECK FEES $52.50 Total Payments: $161.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC: BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. rn q I Ito CITY OF ATLANTIC BEACH _ BUILDING AND ZONING js 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233 j TELEPHONE(904)247-5800 FAX:(904)247-5845 Re: 1665 Beach Avenue The City of Atlantic Beach conducted a preliminary review of Foundation Repair Plans, dated 8/08/2014, which were submitted for 1665 Beach Avenue. The proposed construction does not contravene any local setbacks and zoning codes. At this time,The City of Atlantic Beach has no objections to the proposed project.The project will still need a formal submittal and revie from city staff prior to final approval. Please feel free to contact me at(904) 247-5817 if you have any questions. Sincerely, Jere ubsch Building and Zoning Director 09/16/2014 FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION Division of Water Resource Management FLORIbA 2600 Blair Stone Road,Mail Station 3522 Tallahassee,Florida 32399-2400 Telephone(850)245-8336 GENERAL PERMIT NOTICE TO PROCEED Permittee Name: Permit Number: DU-468 GP Ocean Grove Partners LLP Permit Expires: October 29,2016 c/o Hygema House Movers Inc. Post Office Box 2655 Jacksonville,Florida 32203 You are hereby granted final authorization to proceed with construction or activities authorized by this notice. Authorized work must conform to the project description, approved plans, all the conditions of Section 6213- 34.050, Florida Administrative Code,and any preconstruction requirements. Project Description: Foundation repair for an existing single-family dwelling, including the following: Install eight new CMU piers beneath the dwelling, 4 push piers beneath the seaward screened porch, replace 30 linear feet of beams, repair floor joist and level existing dwelling. All work is to be located landward of the General Permit Line. Project Location: Between approximately 173 feet and 223 feet North of the Department of Environmental Protection's reference monument R- 46, in Duval County. Project Address: 1665 Beach Avenue, Atlantic Beach. Special Instructions: A preconstruction conference is required. Contact Trey Hatch at(904) 655-1765 to schedule a conference.The permittee shall comply with all general permit conditions. Questions regarding this notice should be directed to the undersigned at the above address. 10/29/2014 Keith Davie,Permit Manager Date py.p.gnenpwa.e..p ' p[piblLOe{tdFliunali Pu.Nut � Weaver � P Jam, 10/29/2014 Deputy Clerk Date KLD/dw cc: Permit File Permit Information Center Trey Hatch,Field Inspector-trey.hatch@dep.state.fl.us Ocean Grove Partners LLP, Property Owner- rootlasiaaol.com Hygema House Movers Inc.,Agent-hhm 1986@bellsouth.net City of Atlantic Beach,Building Official i Post Conspicuously on the Site DEP Form 73-102(Updated 9/05) FINAL CERTIFICATION Coastal Construction Control Line Program a Division of Water Resource Management Florida Department of Environmental �oallPermit Number. D11468GP Mail to: Protection 2600 Blair Stone Road Mail Station 3566 permittee Name: Ocean Grove Partners LLP Tallahassee,Florida 32399-2400 E-Mail to: CCCL@dep.state.fl.us This is to certify that the work under the permit for construction or other activities seaward of the coastal construction control line pursuant to Section 161.053,Florida Statutes,was inspected by the undersigned and was found to be acceptable and satisfactory in accordance with the approved plans and project description and with all conditions of the permit. All permitted construction or activities have been completed, and no unpermitted construction or activities have occurred. Location and elevations specified by the permit and approved plans have been verified and found to be correct, and topography and vegetation have been either preserved or restored as required by the permit. FOR WORK INCLUDING: Foundation repair for an existing single-family dwelling, including the following: Install eight new CMU piers beneath the dwelling, 4 push piers beneath the seaward screened porch,replace 30 linear feet of beams,repair floor joist and level existing dwelling. All work is to be located landward of the General Permit Line. NOTE: Any deviations from the permit and any portions of the permitted work not actually performed shall be noted and described in detail as an exception to this certification. Signature of Engineer or Architect Date Typed or Printed Name of Engineer or Architect (Seal) State of Florida Registration Number DER FQM 73-115a�Updawd 1141 j) i Florida Department of Environmental Protection(DEP) Division of Water Resource Manageme-it FiOT Blair2600 'on 3522 ssee,Florida 32 9-2400 Tallahassee, 9 (850)488-7708 t . FLORIDA General Conditions for General Permits Section 6213-34.050,Florida Administrative Code (1) The terms, conditions, requirements, limitations, and restrictions set forth in this section are general conditions and are binding upon the permittee for all General Permits in this rule chapter. These conditions are enforceable under Chapter 161, F.S. (2) Prior to commencing construction activities under this rule chapter, which are authorized by this Bureau, a formal notification from the Bureau must be received authorizing the proposed activity. The notice form, DEP Form 73-102 (Updated 7/05), entitled "General Permit Notice to Proceed" is hereby incorporated by reference. (3) A copy of the Notice to Proceed and the approved plans shall be conspicuously displayed at the project site for the duration of the activity. (4) A preconstruction conference shall be held at the site between the contractor, the owner or authorized agent, and a staff representative of the Bureau prior to the initiation of any work permitted under this rule chapter. The purpose of this conference is to establish the manner in which the proposed work will be performed to ensure adequate protection of the beach and dune system and native vegetation. The optimum siting of the construction fence and any walkover shall be determined during the pre-construction conference by the staff representative in order to provide maximum protection to the existing vegetation located on the site. The locations of the proposed structures shall be staked out for the preconstruction conference. (5) A foundation location certification shall be completed by the applicant, signed by a surveyor licensed in the state of Florida, and submitted to the Bureau immediately following installation of the foundation piles for the most seaward major structure authorized by this General Permit. This certification shall be submitted using DEP Form 73-114B (Updated 9/05)entitled "Foundation Location Certification,"which is hereby incorporated by reference. The Department shall perform such verification within seven (7)working days of receipt of the certification. If the Department does not respond to the certification within seven (7)working days then construction may proceed. No further work may proceed until the Department has verified the foundation location information and authorized additional work to proceed. (6) The permittee shall carry out the construction or activity for which the permit was granted in accordance with the plans and specifications that were approved by the Department as part of the permit. No other construction or activities shall be conducted. No modifications to project size, location, or structural design are authorized. (7) Permits shall be suspended or revoked for good cause, in accordance with Section 161 M53(20), F.S. In addition, a permit shall be suspended, revoked or modified by the Department if shoreline changes occurring subsequent to issuance of the permit render the previously authorized activities inconsistent with Chapter 161, F.S., or Chapter 626-34, F.A.C. (8) The assessment of civil fines or issuance of an order to alter or remove any work, or both, may result from work performed that was not authorized in the permit, pursuant to Section 161.054, F.S., and Chapter 626-54, F.A.C. (9) The permittee shall conduct the construction or activity authorized under the permit using extreme care to prevent any adverse impacts to the beach and dune system, marine turtles and their nests and nesting habitat, and adjacent properties and structures. (10) The permittee shall allow any duly authorized member of the staff to enter upon the premises associated with the project authorized by the permit for the purpose of ascertaining compliance with the terms of the permit and with the rules of the Department. (11) The state of Florida, the Department, or its officers and employees shall in no way be liable for any damage, no matter how occasioned and no matter what the amount, to persons or property which might result from the construction or activity authorized under the permit and from any and all claims and judgments resulting from such damage. (12) The permittee shall not disturb existing beach and dune topography and vegetation except as expressly authorized in Part II of this rule chapter. Before the project is considered complete, any disturbed topography or vegetation I shall be restored as prescribed in the permit with suitable fill material or revegetated with appropriate beach and dune vegetation. (13) No construction, operation, transportation, or storage of equipment or materials is authorized seaward of the dune crest or rigid coastal structure. (14) All fill material placed seaward of the Coastal Construction Control Line shall be sand that is similar to that already existing on the site in both coloration and grain size. All such fill material shall be free of construction debris, rocks, clay, or other foreign matter, and shall be obtained from a source landward of the Coastal Construction Control Line. (15) To ensure compliance with this rule, all topographic restoration and revegetation work is subject to the approval and acceptance by the Department staff. General Conditions for General Permits(effective November 21,2005) Pale I (16) No temporary lighting of the construction area is authorized during the marine turtle-nesting season (May 1 through October 31 of each year for all counties except for Brevard, Indian River, St. Lucie, Martin, Palm Beach and Broward. Nesting season for these counties is the period from March 1 through October 31 of each year.). (17) This permit is issued to a specified property owner and is not valid for any other person. (18) This General Permit does not eliminate the necessity to obtain any required federal, state, local, and special district authorizations prior to the start of activity authorized by Part II of this rule chapter. (19) Elevated walkovers that provide access to the beach shall meet the following design criteria: (a) The decking of the walkover structure shall be elevated a sufficient distance above the existing vegetation to allow for sand build-up and clearance above the vegetation and not exceed 4 feet in width. (b) The piles for the walkover structure shall not be greater that 4-inch by 4-inch posts and shall not be encased in concrete. (c) The walkover shall extend at least up to the existing line of vegetation but not farther than 10 feet seaward of the vegetation. (d) Where armoring exists and no vegetation line exists seaward of the armoring, the walkover shall extend a maximum of 5 feet seaward of the armoring. (e) The optimum siting of the walkover structure shall be determined by the staff representative during the pre-construction conference to provide maximum protection to the existing dune topography and vegetation located on the site. (20) The duration for all permits is two years. (21) Final certification, by an engineer or architect licensed in the state of Florida, shall be provided to the Department within thirty(30) days following completion of the work on major structures. This certification shall state that all locations and elevations specified by the permit have been verified; all major structures are specifically constructed in accordance with Chapter 6213-34, F.A.C.; other construction and activities authorized by the permit have been performed in compliance with the plans and project description approved as a part of the permit, and all conditions of the permit; or shall describe any deviations from the approved plans, project description or permit conditions, and any work not performed. Such certification shall not relieve the permittee of the provision contained in subsection 62B-34.050(6), F.A.C. The final certification shall be submitted using DEP Form 73-115B (Updated 7/05), entitled "Final Certification,"which is hereby incorporated by reference. General Conditions for General Permits(effective November 21,2005) Page 2 NV300 011NV11V 2 a W � UI im I 1z Vo Y co Li V94 - •d _ €��Y`�$ -� Io-•� � o FSI s 9 PN f N3nb N0b38 /O2fb �31n08 Nb30p z gnwO > n• =Z� 0 < <= w �o UWSO r y W Li 2 owz U• tkv i 11=•I�I .. a��y 'o� � ao `;Y8HE Ys `s psa a� 44 ^3 a�5•�3` izw •^ dg i [Q Sa fi H g K Y� 3EL� 8� Y � ao •ggc � a W j j dy 3a �yY Y8 y C •g=8e 3 8 II—r aN 6 Eq � tCC a� � Ir z § gRS $ a W�pZ'� o W 2 to 4 W I Z ay.U. Jai 41 r ))� � �� •$''� � i ?PE �i $ dad � � � V gas p Y� �Y S=• a F6 s �l`o a� Yt• �kip�d 1z' 1}-- $6.,, Y.S YE 1S ek dG�� C o N FIs a 3- � a I� a p3 aY y€es 2t Mil j ?gY6 Sg� 'az's �f•b z� IIIc u ��§ "s oaf:tzgao�� ..:3 a �,. • A-i HYGEMA HOUSE MOVERS, INC. Richard Mark Boyles BONDED HOUSE MOVERS PHONES: President Where Skill and Experience Count (904) 764-9509 .filbert J. Boyles,Jr. CALL US FOR FREE ESTIMATES (904) 282-4212 Secretary/Treasurer P.O. BOX 2655•JACKSONVILLE,FLORIDA 32203 FAX (904) 282-0595 CB C056929 _ CRCO_ 49210 September 2,2014 City of Atlantic Beach Building Department Attn: Don Arlington REF 1665 Beach Ave.,Atlantic Beach 32233 This letter is in reference to the work to be completed at 1665 Beach Ave., Atlantic Beach, FL. The work to be completed is foundation repair only. We are adding extra support piers under the building along with replacing bad sill beams and floor joist. We are also installing stabilization piles on front porch area. All work is in the original footprint of house. In no way will we be increasing the total height of building from its original height or from its original footprint on lot. The prints that we have submitted to your building department have been reviewed by DEP and verbally okayed by. We need a letter to DEP to submit for final permit. Your help would be sincerely appreciated. Thank Albert"Jay" Boyles-HYGEMA HOUSE MOVERS, INC. OFFICE (904)764-9509 CELL (904) 509-3462 GEMA HOUSE MOVERS, INC. Richard Mark Boyles BONDED HOUSE MOVERS PHONE& President Where Skill and Experience Count (904) 764-9509 Albert J. Boyles,Jr. CALL US FOR FREE ESTIMATES (904) 282-4212 Secretary I Treasurer P.O. BOX 2655 -JACKSONVILLE,FLORIDA 32203 FAX (904) 282-0595 CB C056929 CRC049210 September 2,2014 City of Atlantic Beach Building Department Attn: Don Arlington REF 1665 Beach Ave.,Atlantic Beach 32233 This letter is in reference to the work to be completed at 1665 Beach Ave., Atlantic Beach, FL. The work to be completed is foundation repair only. We are adding extra support piers under the building along with replacing bad sill beams and floor joist. We are also installing stabilization piles on front porch area. All work is in the original footprint of house. In no way will we be increasing the total height of building from its original height or from its original footprint on lot. The prints that we have submitted to your building department have been reviewed by DEP and verbally okayed by. We need a letter to DEP to submit for final permit. Your help would be sincerely appreciated. Than y u, Albert "Jay" Boyles-HYGEMA HOUSE MOVERS, INC. OFFICE (904)764-9509 CELL (904)509-3462 Iry nYGE A HOUSE MOVERS, INC® Richard Mark Boyles BONDED HOUSE MOVERS PHONES: President Where Skill and Experience Count (904) 764-9509 Albert J. Boyles, Jr. CALL US FOR FREE ESTIMATES (904) 282-4212 Secretary I Treasurer P.O. BOX 2655 •JACKSONVILLE,FLORIDA 32203 FAX (904) 282-0595 CB C056929 CRC049210 September 2, 2014 City of Atlantic Beach Building Department Attn: Don Arlington REF 1665 Beach Ave.,Atlantic Beach 32233 This letter is in reference to the work to be completed at 1665 Beach Ave.,Atlantic Beach, FL. The work to be completed is foundation repair only. We are adding extra support piers under the building along with replacing bad sill beams and floor joist. We are also installing stabilization piles on front porch area. All work is in the original footprint of house. In no way will we be increasing the total height of building from its original height or from its original footprint on lot. The prints that we have submitted to your building department have been reviewed by DEP and verbally okayed by. We need a letter to DEP to submit for final permit. Your help would be sincerely appreciated. Tha k You, Albert"Jay" Boy es-HYGEMA HOUSE MOVERS, INC. OFFICE (904)764-9509 CELL (904)509-3462 City of Atlantic Bea-%-i APPLICATION NUMBER s 1S Building Departme (To be assigned by the Building Department.) r 800 Seminole Road Atlantic Beach, Florida 32233-5445 J Phone(904)247-5826 • Fax(904)247-5845fb E-mail: building-dept@ccab.us Date routed: l City web-site: http://www.uoab.us I it APPLICATION REVIEW AND TRACKING FORM Property Address: /lY (! /� ell /7rb Department review required Yes o uilding Applicant: �'i/lC anning &Zoning Tree Administrator Project: ��(,-�jal Q� / / /G./ Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review G.Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of EnvironmE •'al Protection Florida Dept. of Transports n St.Johns River Water Man4gement District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review P�p roved. []Denied. (Circle one.) Comments: 71C)C PLANNING &ZONING Reviewed by: leii 0i Date: TREE ADMIN. Second Revic'v,r: ❑Approved as revised. ❑Denie . 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 BUILDING PERMIT APPLICATION ± i CITY OF ATLANTIC BEACH FILE COPY 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904)247-5845 Job Address: &Q-ch &U e- • Oita-id;c-& EL Permit Number: Legal Description 15`10 o 9-df.,A-7 F ,a A Parcel# 16765-1-0000 Floor Area oft Sq.111. Sq.Ft Valuation of Work$ 10, 10 0.0 U 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 eside If an existing structure,is a fire sprinkler system installed? (Circle one): es No N/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed:7x04 1 k) new p0 ctI- bI ey-6• K'e la c-e- a-p;ru;c•3CLr o-F b'' Xb'' Si1ll?eu.�.i� W esu b"K(C'� ✓'P55 �w ��r�.tled.�DE'��rg . It �✓��>�" '��DO✓ Lei 57- (krl�e✓� k r r v c fla,(I inti-c(2 6-e cw.�Ct c IL 1 r Q e vn 6 2 4� p v,s �� P" �7 On c 0 r r1 a o-50 P p reh rooerty Owner Information: f-D 5`ta /i Z-e ~ r,- J e v e Name:001 eAA Gr o v f— pq r-t vi e r'g L l-L' 1' Address:eU 3 City State M Zip 3jaa w Phone Cq d l E-Mail or Fax#(Optional) Contractor Information: Company ame: 1 �1'14li r�t0�C 3 e rn D e r s Zn Quali�ing Agent: a Address: City J a C�K so n V; l l e- State r t— Zip 3.26,1-� Office Phone D &4-16-0 9 Job Site/Contact Number Fax#(100A 8a-O S`fS State Certification/Registration# 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 pa de to obtain a permit to dohe work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit athat all work will be performedtomttstandardsofalllawgthisjurisdiction. This permit becomes null d void tf work isnoommenced within six(6)months, or if construction or work is suspended or abandoned for aperiod ofsix months at any time after work is commenced. !understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters, 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. I here b certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied ith whether sppeci ie rein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other feder ,state, or l lary reg ing construction or the performance of construction. p l GCS Signature of Owner �����BX�C� ��OCl L`"a� " Signature of Contractor Print Name �'� C • l�c�T' Print Name ......................................................................................................................................... l....... . . ...... ........._!._!........._` ... L.................................. ........ Swor�tt and subs ibed before me Sworn and subscri ed before- this 1 T`''"Da of_ _ 20 this May of 20 t NO LINDA M, PAIDQ�TT f., 't MY COMMISSION#FF122910 ' My COMMi681CN a�W22910 A" 29,201 s evised 01.26.10 �XPIRI�6 .����dr,: EXPIRES May °�.go18 Floridallotaryservice.com ,07 398-0153 (407► .Qt rlgrid�0l 6g,Vi6e,�pFp Doc # 2015082229, OR BK 17129 Page 792, Number Pages: 1, Recorded 04/13/2015 at 03:07 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 Notice of Commencement Return to: Name:HYGEMA HOUSE MOVERS,INC. Address: P.O.BOX 2655 JAX.,FL 32203 This Instrument Prepared by: Name:RICHARD M.BOYLES Address:P.O.BOX 2655 JAX.,FL 32203 Property Appraisers Parcel Identification: 169657-0000 SPACE ABOVE THIS LINE FOR PROCESSING DATE SPACE ABOVE THIS LINE FOR RECORDING DATA NOTICE OF COMMENCEMENT Permit No.14-1365 Tax Folio No. 169657-0000 State of Florida County of DUVAL The undersigned hereby gives notice that Improvements will be made to certain real property,and in accordance with chapter 713 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT. Legal description of property(include Street Address,if available) 15-10 09-ZS-29E .22 NORTH ATLANTIC BEACH UNIT 1 S/D 03098 NORTH ATLANTIC BCH UNIT 1 1665 BEACJIAVE ATLANTIC BEACH,FL 32233 General description of improvements INSTALL(8)NEW POURED PIERS. REPLACE APPROX..30 LF OF 6"x6"SILL BEAMS W/NEW 6"x6"PRESSURE TREATED BEAMS REPAIR 2"X8"FLOOR JOIST UNDER BATHROOM HALLWAY AREA. JACK AND RELEVEL INSTALL(41 PUSH PIERS ON CORNERS OF PORCH TO STABILIZE AND RELEVEL Owner's Name OCEAN GROVE PARTNERS LLP Address 1665 BEACH AVE ATLANTIC BEACH FL 32233 Owner's interest in site of the improvement RENTAL Fee Simple Title holder(if other than owner) Address -- Phone: Fax: Contractor HYGEMA HOUSE MOVERS INC. Address P.O.BOX 2655 JAX.,FL 32203 Phone:1904)764-9509 Fax:(904)282-0595 Surety --- Phone: Fax:- Ad r ss ax:Address Amount of Bond$ Lender's Name Address Phone: Fax: Persons within the State of Florida designated by owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7,Florida Statutes. Name Address Phone: Fax: In addition to himself,owner designates Of Phone: Fax: To receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Expiration date of Notice of Commencement(the expiration date is 1 year from the date of recording unless a difference date is specified) �. �C �— • Signature of Owner Printed Name of Owner NOTARY RUBBER STAMP SEAL I have re�j upon th follo ' g Identification of the Affiant /✓ �- 0 a- Cdi 1 `�4 LINDA H. PADGETT Swo a d Lu ri ed of r e t is ay of U/y MY COMMISSION*FF122910 `•?«,� EXPIRES May 20, 2018 Nota S nat e Ia7,Sea-0tb9 eW FIorldsNala Servics.com Printed Name