1089 Main St RERF21-0211 NOCDoc # 2021232372, OR BK 19897 Page 1078, Number Pages: 1,
Recorded 09/07/2021 09:03 AM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
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Permit No. Ter, Forio'No.
Ptaie of FL County of
To whom is may oonL*mt
TZaa tst7damigne'd horeby It-tronu you ttizi Improvements win he made to certain real proparbr, and in
seeoreianas Wi&. sactlon 713 of ti',e Florid_ 6�i,rtes, the fallowing hWormadon is statad III this NOTICE OF
t OM MI!!I'd GMirN'f.
Address of property being improved:
G4nerdi doscliptlrni of Improvements: PIRPIO 8 _� __
Owner
r -
Address
OwnaYs interest in site of xhe hrpmvamort - - - -_-
Fee Simple Tiilsholder (ir other ft,t owrler)y
Name
Address __
ContrecWr ROMANO 3R0'l7IIR$ t2O0i-ING)NC
Address PC BOX 330337 ATI k\*fSC BEACH K- 32233
Phone No. 904-2455649
3urety (ir any)-
--
Address
Fax No, 904-246.48I0
— - — Amount of bond S
Phone No. _ rax Ido.
Name and address of any CersOn making a ioa- :Or the oonstvCaon of the iniproveraerrts.
Name _ _
Address _ ---.
Phone No. - ---�-
-- Fax No.
Name of person. wflhin ha Slate of Fiorlda, o her _her, hinsatf, das;gnated by owner upon whom noJcas or other
documents may be served:
Name DANNY Fn"NO
Address 155 LEIV itt7 SUl i`d'f>C �ACIs 17L 327,33 ---`�—
Phone td0. 904610.8476 _ Fax No, _
In addition addition to himself, olvRer designates the foilo,t ng pt rson to reCeive a Copy of the Llenoes NOiiCa as provided in
Section 713.00 (2) (b), Florida £3tatutes. (Fill in at Owners option).
mama
Address — -
Mone No. Fax No.
avIrauoR Care or Nuuce of COMIenceplent (the oxphaUO" date Is one (1) year Born the date of recording unless aw
dtffemnt date is spedRed): �
-mis SPACE roR RECGRi3i:pt USF fl1\SLY
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