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APPLICATION PROJECT NAME Boynton Beach Medical Pavilion LOCATION 2800 Seacrest Blvd COMPUTER ID 01-55000004 PERMIT # I FILE NO NWSP 01-004 II TYPE OF APPLICATION New Site Plan I AGENT/CONTACT PERSON Chris Kerr, OWNER!APPLICANT Bethesda Healthcare Kilday & Associates, Inc System, PHONE 689-5522 PHONE N/A FAX. 561-689-2592 FAX. N/A ADDRESS 1551 Forum Place, Suite 100A ADDRESS 2815 South Seacrest Blvd., West Palm Beach, Fl33401 Boynton Beach, FL 33435 Date of submittal/Proiected meetinl! dates. SUBMITTAL / RESUBMITTAL 06/06/01 1ST REVIEW COMMENTS DUE 7/10/01 PUBLIC NOTICE N/A TRC MEETING 7/31/01 PROJECTED RESUBMITTAL DATE N/A ACTUAL RESUBMITTAL DATE N/A 2ND REVIEW COMMENTS DUE N/A LAND DEVELOPMENT SIGNS POSTED 8/24/01 (SITE PLANS) PLANNING & DEVELOPMENT BOARD 08/28/01 MEETING COMMUNITY REDEVELOPMENT N/A AGENCY BOARD CITY COMMISSION MEETING 09/04/01 COMMENTS Variance and Height Exception also submitted for this project. S \Planning\SHARED\WP\PROJECTS\Boynton Beach Medical Pavilion\NWSP\2001 PROJECT TRACKING INFO.doc Kilday & Associates Landscape Architects 1 Planners 1551 Forum Place, Suite 100A West Palm Beach, Florida 33401 (561) 689-5522 Fax (561) 689-2592 www kildayinc.com June 6,2001 C .:>:::.pJ Kdctc.-. y'c.c. COM Ms. LUSIa Galav, Senior Planner CIty of Boynton Beach Zomng DIvIsIon 100 E. Boynton Beach Blvd. Boynton Beach, FL 33435 RE. Site Plan submittal; East Boynton Medical Arts Pavilion Ourfile: 868.28 DearM7L~- Please find attached a complete SIte plan applicatIon submitted by our office on behalf of the applIcant for a medIcal office bUIldmg to be located at the southeast comer of Seacrest Blvd. and SE 27th Ave. ThIS submIttal package mcludes. . 12 SIte Plan Review applIcations . SIgned consent forms from the property owner, Bethesda Healthcare Systems, Inc as well as from the applicant, Boynton East MedIcal Investors, LTD . A letter requestmg a heIght WaIver for our entry feature and parapet . CertIfied copIes of the Warranty Deed . 12 copies of signed and sealed surveys of the property . 12 copies of site plan . 12 of the landscape plans . 12 copies of the preliminary engineenng plans . 12 copIes of elevations and floor plans . All applicable fees for the SIte plan applIcatIOn and height waiver request MedIcal offices are a permitted use m the C-l Zomng DIstnct. As we have dIscussed, we wIll also be submIttmg a variance applIcatIOn seeking relief from the bUIldmg heIght requirements and the number of reqUIred off-street parking spaces. Smce there IS existmg 23,149 sf medIcal office use on the property, the net mcrease m traffic generated under this proposal will only be 196 trips per day Therefore, no formal traffic analysIs IS necessary Please call me WIth any questions or comments. Sfi~ ,,;err KIlday & ASSOCIates, Inc enclosures .-Y OF BOYNTON BEACH, FLORID. PLANNING & ZONING DIVISION SITE PLAN REVIEW APPLICATION FOR NEW SITE PLANS & MAJOR MODIFICATIONS TO EXISTING SITE Application Acceptance Date ill/)( ~ Fee Paid D Receipt Number' 2L/f15' This application must be filled out completely, accurately and submitted as an original to the Planning and Zoning Division. TWELVE COMPLETE, sequentially numbered, ASSEMBLED AND STAPLED sets of plans including a recent survey and appropriate fee shall be submitted with the application for the initial process of the Site Plan Review procedure AN INCOMPLETE SUBMITTAL WILL NOT BE PROCESSED Please print legibly (in ink) or type all information GENERAL INFORMATION 1 Project Name East Boynton Medical Arts Pavilion 2 Applicant's name (person or business entity in whose name this application is made) Boynton East Medical Investors, L TD Address. 3801 PGA Blvd. Suite 555 Palm Beach Gardens, FL 33410 Phone 630-5055 Fax: 630-4055 3. Agent's Name (person, if any, representing applicant) Kilday & Associates, Inc. Address. 1551 Forum Place, suite 100A West Palm Beach, FL 33401 Phone 689-5522 Fax: 689-2592 4 Property Owner's (or Trustee's) Name Bethesda Healthcare System, Inc. Address 2815 South Seacrest Blvd. Boynton Beach, FI 33435 5 Correspondence to be mailed to agent only; if no agent, then to applicant unless a substitute is specified below'* Please send all correspondence to agent. *This is the one address to which all agendas, letters and other materials will be mailed 6 What is applicant's interest in the premises affected? (owner, buyer, lessee, builder, developer, contract purchaser, etc.) The applicant is the lessee. 7 Street address or location of site 2800 S. Seacrest Blvd. 8 Property Control #. 08-43-45-33-14-000-0142 Legal description of site Please see attached legal description and survey 9 Intended use(s) of site Medical offices Planning and Zoning Division - Rev 10/15/1998 H:\CLlENTS\0868 RENDINA\0868.28\CORRESPONDENCE\SITEPLAN.DOC 10 Developer or Build& Rendina Companies 11 Architect Davis Stokes 12. Landscape Architect Kilday & Associates, Inc. 13. Site Planner' Kilday & Associates, Inc. 14 Engineer' Difonte Consulting, Inc. 15 Surveyor" Accurate Survey 16 Traffic Engineer' None 17 Has a site plan been previously approved by the City Commission for this property? No 18. Estimated construction costs of proposed improvements shown on this site plan This is a raze and rebuild development. Exact construction costs will be provided at time of building permit. II SITE DATA The following information must be filled out below and must appear, where applicable, on all copies of the site plan 1 Land Use Cateaorv shown in the Comorehensive Plan Office Commercial 2. Zonina District C-1 Area of Site 2.05 acres 89.162 sq ft. 3 4 Land Use -- Acreaae Breakdown a. Residential, including acres o % of site surrounding lot area of grounds b Recreation Areas * acres o % of site (excluding water area) c. Water Area acres o % of site d Commercial 2.05 acres 100 % of site Total area of site 2.05 acres 100 % of site 5. Surface Cover a. Ground floor building area ("building footprint") 0.33 acre 16 % of site b Water area acres 0 % of site c, Other impervious areas, including paved area of public & private streets, paved area of parking lots & driveways (excluding landscaped areas), and sidewalks, patios, decks, and athletic courts. 53.467 sf (1.23 acres) ~% of site d Total impervious area.1&....- acres ~% of site e Landscaped area 21.108 sf (0.48 acres) 24 % of site *inside of parking lots (20 sq.ft. per interior parking space required - see Sec. 7.5-35(g) of Landscape Code) (940 sf required, 1,306 sf provided) f Other landscaped areas ,_ acres ---2....% of site g, Other pervious areas, including golf course, natural areas, yards, and swales, but excluding Planning and Zoning Division - Rev 10/15/1998 H:\CLlENTS\0868 RENDINA\0868.28\CORRESPONDENCE\SITEPLAN,DOC water areas acres o % of site - h Total pervious areas acres % of site Total area of site 2.05 acres 100 % of site 6 Floor Area a. Residential b Commercial/Office c. Industrial/Warehouse d Recreational e Public/Institutional f Other (specify) g. Other (specify) sq ft. 29.173 sq ft. sq ft. sq. ft. sq ft. sq ft. sq ft. 29.173 sq. ft. h Total floor area 7 Gross Densitv dwelling units per acre 8 Maximum heiaht of structures on site 28* feet 2 stories *subject to variance request 9 Reauired off-street oarkina a. Calculation of required number of off-street parking spaces b Off-street parking spaces provided on site plan 1 space per 200 sf = 148 spaces reauired ! ,I I f(p 140 spaces provided* * subject to variance request Representative of the project must be present at all Technical Review Committee, Planning and Development and City Commission meetings held to review this project. Planning and Zoning Division - Rev 10/15/1998 H:\CLlENTS\0868 RENDINA\0868.28\CORRESPONDENCE\SITEPLAN.DOC III CERTIFICATION (I) (We) understand that this application and all papers and plans submitted herewith become a part of the permanent records of the Planning and Zoning Division (I) (We) hereby certify that the above statements and any statements or showings in any papers or plans submitted herewith are true to the best of (my) (our) knowledge and belief This application will not be accepted unless signed according to the instructions below Signature of Owner(s) or Trustee, of Authorized Principal if property is owned by a corporation or other business entity Date <)e? ~ -CoIJSQjJ~ ~ IV AUTHORIZATION OF AGENT Signature of Authorized Agent Date (I) (We) hereby designate the above signed person as (my) (our) authorized agent in regard to this application Signature of Owner(s) or Trustee, or Authorized Principal if property is owned by a corporation or other business entity Date SPACE BELOW THIS LINE FOR OFFICE USE ONLY Review Schedule Date Received Technical Review Committee Planning & Development Board Community Appearance Board City Commission Date Date Date Date Stipulations of Final Approval Other Government Agencies/Persons to be contacted. Additional Remarks. A REPRESENTATIVE OF THE PROJECT MUST BE PRESENT AT ALL TRC, P&D AND CC MEETINGS HELD TO REVIEW THIS PROJECT Planning and Zoning Division - Rev 10/15/1998 H:\CLlENTS\0868 RENDINA\0868.28\CORRESPONDENCE\SITEPLAN.DOC III. CERTIFiCATION (I) ~ e) understand that this application and all papers and plans submitted herewith become a part of the permanent records of the Planning and Zoning DMsion (I) ~e) hereby certffy that the above statements and any statements or showings in any papers or plans submitted herewith are true to the best 01 (my) (our) knowledge and belief This application wiD not be accepted unless signed according to the instructions below. By' BOYNTON EAST MEDICAL EQUITY INVESTORS, LID , a Florida limited I / partnership, its sole general partner V .J/~/ O( Date SIgnature of Applicant BOYNTON EAST MEDICAL INVESTORS, L TD , a Florida limited partnership By' BOYNTON EAST MEDICAL EQUITY CORPORA , a Florida corporation, its sole gene r By' Name' PatrIck J fliSal'.'9 Title. Vice President IV AUTHORIZATION OF AGENT Kilchly ~ Ine. Signature of Authorized Agent .- c.~lK\ > ~r to" ij:61 Date (I) ~e) hereby designate Kildav & Associates. Inc. as (my) (our) authorized agent in regard to this application. (,/S/ot BOYNTON EAST MEDICAL INVESTORS, L TD , a Florida limited partnership Date By' BOYNTON EAST MEDICAL EQUITY INVESTORS, LTD , a Florida limited partnership, its sole general partner By BOYNTON EAST MEDICAL EQUITY CORPORA nON, a Florida corporation, its :legener~ y. a c lvo Name ... II 'd t v u;c I C:;~l tFll Title Sent By RENDINA COMPANIES, ---- MA! ~~. ).tI" ~ jjAM I r j. i I r r i i: 6551208, lUll \ A~~Ul.,lAlt~ Jun 5 01 9 05AM, Page 3/3 NO. 262 f 2 Boynton East Medical :1, hereb glve:oonsent to Investors. Ltd _ . and their authoriZed agent to act on my behalf. to submit this application and all required and documents, and to attend and represent me at aU meetings and public :hearin pertaining to the subject property located in the City of Boynton Beach. I h8",by \:9ive CO sent t~9ynton Ea"t: M~d. TnVRt: T.l"tW agree to all terms or oondlUons that may :arlse as part of the approval of this application. 1:1 here certify that I have full knowledge that the property I have an ownership interest in liS the & ;ect Of this appDcatJon. I further certify the statements or information made In any IPaper 0 plans submitted herewith are true and correct to the best of my knowledge. IO~~ mFO~~~:L r' ~{LP ;/tit ','{Name) {Signature . ~I ~l)O T ti ~tAC ~T ~AJ"'ON l>)ZACH fl330/35 :(Addres ) '91.9J). (City, 'State. Zip) ) I: j:Notary ublJc Information: _ . IThe 10' going i~m.nt was ecl<nowledgecl before me tl1IS~ clay 0' ~ 12Q D by 6,,1e\ ~ B !--h II (name of person acknOWledglng~ HelshU I:person Iy known to me or has produced (type of identification) !:as Iden flcatlon and did/did not take an oath. (circle correct response) l: ~ ct/t6 I. Vu- C /. - 'gnature) !MY Co mission expires on: ~~! 10./ 0 ~ I j. I: I. I: I I: l NotarY. Seal or Stamp NMMY PUBLIC ltT~TE OF FLORIOI' KAREN ! POTO~KY COMMISSION II ccn4072 EXPIRES 311212002 IONDED THRU ASA ',aa-NOTARY1 I';"' RIDER TO SITE PLAN APPLICATION The undersigned as applicant for Final Site Plan Approval does hereby acknowledge. represent and agree that all plans. specifications. drawings. engineering, and other data submitted with this application for review by the City of Boynton Beach shall be reviewed by the various boards, commissions, staff personneJ and other parties designated, appointed or employed by the City of Boynton Beach. and any such party revieWing the same shall rely upon the accuracy thereof, and any change in any Item submitted shall be deemed material and substantial. The undersigned hereby agrees that all plans, specifications. drawings, engineering and other data which may be approved by the City of Boynton Beach. or its boards. commissions, staff or designees shall be constructed In strict compliance With the form in which they are approved. and any change to the same shall be deemed material and shall place the applicant in violation of this application and all approvals and permits which may be granted. The applicant agrees to aUow the Clty of Boynton Beach all rights and remedies as provided for by the applicable codes and ordinances of the City of Boynton Beach to bring any violation Into compliance, and the applicant shall indemnify. reimburse and save the City of Boynton Beach harmless from any cost, expense, claim. liability or any action which may arise due to their enforcement of the same. S day of 'Jdn e . 20fU Q~p'OWLEDGED. AND AGREED TO this W ss,>>-- ~ L)~^-U- t-buJ BOYNTON EAST MEDICAL INVESTORS, L TD , a Florida limited partnership Witness By' BOYNTON EAST MEDICAL EQUITY INVESTORS, LTD , a Florida limited partnership, its sole general partner By BOYNTON EAST MEDICAL EQUITY CORPORATION, a Florida corporation, its sole gener er By' Name Title Q2)~D DIFC :TE CONSUL TING, INC. 208f"- PPALOOSA TRAIL WELL..__ ~GTON, FLORIDA 33414 TEL. & FAX. (561) 792"7551 WWW.DIFONTE.COM CERT OF AUTHORIZATION 8432 BETHESDA MEDICAL ARTS PAVILION Seacrest Boulevard Boynton Beach, Florida DRAINAGE CONFIRMATION June 6, 200 I The 2.05 acre project SIte IS located along the east side of Sea crest Boulevard - at the southeast comer of the intersection WIth SE 27th Street. The SIte IS situated WIthIn the corporate limIts of the City of Boynton Beach, Flonda. Our office has researched the available dramage data assocIated WIth the project SIte and Its VIC1lllty The SIte is sItuated WIthIn the jurISdICtlOnal boundanes of the City of Boynton Beach and South Flonda Water Management DIStrICt. Based on the record plans for the stormwater management system for the adjacent Improvements to Seacrest Boulevard, SE 2Jth Street, SE 1 st Place and our subsequent field observatlons, It appears that pIped dramage facilitles have been constructed to accommodate the runoff from the Improvements proposed by tills project. The project area and the project SIte's dramage system are served by the Intracoastal Basm. We enVISIon an on-SIte retention system will be designed and nnplemented to provIde for both water quality and quantlty to meet the reqUIrements of the JurISdictIOnal water management agencIes. The proposed on-site drainage system IS planned to dIscharge to an adjacent dramage system and ultImately outfall to the Intracoastal Basin VIa the pIped dramage system for the areas street system. Water quality standards are planned to be met with a senes of exfiltratlon trenches and! or dry swales. It is our opmion that an on-site dramage system can be nnplemented to proVIde servIce for the antlcIpated level of development at the referenced SIte to adhere to the City of Boynton Beach, Palm Beach County and the South Flonda Water Management DIstnct regulatlons. Eug!b:{!!/$ ~ Flonda Registratlon 41885 C:\Dci\Projects 01\01010 Bethesda Moo Arts Pav\dminstale."J)d Feb-18-2809 02:86pm 00-060111 ORB 1 161"7 Pg 1 708 Con 1,451,..00 Doc 10,158.00 I. ............a....II. TIllS INSTRUMENT PREPARED BY Rebecca S. Trinkler, Esq. Robert M TrinkJer, P.A. PO. Box 1814 Dania. Beach, Florida 33004 RErn\lN TO' 1 Joel T. Strawn, Esq. Strawn, Monaghan &; Cohen, P.A. 54 Northeast Fourth Avenue Delray Beach, Florida 33483 WARRANTY DEED mIS DEED, made this 16+'" day of February, 2000, between TAMAT INVESTMENTS INC., a Florida corporation, whose mailing address is clo POBox 1814, Dania Beach, Florida 33004 (the "Grantor") and BETHESDA HEALmCARE SYSTEM, INC., a Florida non-profit corporation, whose mailing address is clo Robert B Hill, President, 2815 South Seacrest Boulevard, Boynton Beach, Florida 33435 (the "Grantee"). WITNESSETH, that said Grantor, for and in consideration of the sum of TEN AND NO/IOO ($10) DOLLARS and other good and valuable consIderation to said Grantor m hand patd by satd Grantee, the receipt whereof IS hereby acknowledged, has granted, bargained and sold to the said Grantee, and Grantee's successors, administrators and assigns forever, the followmg described lands, situate, lymg and bemg in Palm Beach County, Flonda, to-wit: See legal descnption set forth on Exhibit "A" attached hereto and Incorporated herein by reference. PROPERTY TAX IDENTIFICATION NO(S) 43-45-33-14-000-0142 SUBJECT TO' 1 Taxes and assessments for the year 2000, and subsequent years, 2 Applicable zoning and/or restnctlOns and regulations imposed by governmental authorities; 3 Covenants, conditions, easements, restnctions, limitations, reservations, dedications and other matters of record, without intending to reimpose the same; and TOGETHER With all the tenements, hereditaments and appurtenances thereto belonging or In any way appertaining. Page 1 of2 lJriB 11617 Pg 170'9 TO HAVE AND TO HOLD the same in fee simple forever And the said Grantor does hereby fully warrant the title to saId land, and Will defend the same against the lawful claims of all persons whomsoever "Grantor" and "Grantee" are used for singular and plural, as context requires. IN WITNESS WHEREOF, Grantor has hereunto set its hand and seal as of the day and year first above wrItten. ~ THE FOREGOING INSTRUMENT was acknowledged before me this f S- day of February, 2000, by MATTHEW WOHL, as President, and TAMARA WOHL, as Vice President, of T AMA T INVESTMENTS INC., a Flonda coI'J>C!ration, on behalf of the corporation, who are personally known to me ~ Ci' whg h:fh~ --produG€xL ~ '_ , as identJ.fi thm:- SIgned, sealed and dehvered In our presence. WITNESSES (Name-please print) STATE OF FLORIDA COUNTY OF MIAMI-DADE ~~~... ESTBlE BLAIIMIRSQUY !.'iJ>>~ "., aIIIIS8KIN , CC 817117 ! '. . = EXPIRES: IIlMndIIr 18. 2lIDt ~Rr" . 8andId 1llnI....., NlIII ~ My Commission Expires: TAMAT INVESTMENTS INC., a Florida corporation ByQrMV'~ MA TIHEW WOHL, President ATTEST ~~~ TAMARA WOHL, Vice President SS. Name of Notary (please pnnt) Commission No. Page 2 of2 , r ORB 1 1 6 1"7 Pg 1"710 DOROTHY H. WIlKEN, CLERK PB CO\JfTY, Fl LEG EXHIBIT "A " A parcel of 1<1011 ill "ection 'n. Towl)!';hip r,5 <;nnth, Rnnr,e /.3 F.n~t. PnJm nf't1c-11 LOIIIll.y,Horidn, Ilr ill!, IIIIH(' pnrl illllarl}' c11'~lJillf'll a f,dl".,.., Coumencinn at "[lIe iutersectiun of 1:h~ Ea:::lcrly righ.-of liar Unc- of ~('n("rC$L DoulevanJ. ,(ah;n Iwmm ns UOYllLoll-})nlray 'klloo} HO;}l!) wilh tile f,m:l line of tJ.!1 West qunrtcr (\~ 1/(1) o( Tract II, of lhe ~;lIl1divi~;jOIl ()( said Sel.l;oll 'IJ. aCl:or(Jil18 to thcJ'Jal thereof /I reCllnlcu.i1l PlnL lIool< I, ill l'ilf~C 4, nr lhe Puldjc Records of Palm Deneh COllllly Florilhl,'~C"'''c5~J".J] dL'grccs 51, mi"ut.(!:,> 10 seconds \'e~:1. (nssumcd) a.lolln the J.:'"]~I(:r/y I-illht-uf-way or S('ncn~:'lt U"ulc:vnnl ar:c:r)rd.ln1; to the Pint uf (.(\y-lfar I~stat(.:~. a~ H'cllnletl in PInl. Bonk 2/, 01: Pag.. J 10, Qr tha I'lIbl ir Itccords (If f'nJm I.I(mc:h CUIIIII y, Flol'ido n dj!lt.:)l\{:~ IIr (i Olt f(>cl. 1 f, I-h.: 1'01111: l,f nC:I~j,.nillg ll,cnc:C' lonLinue ',oullt J~ llr.I:I-e(::; 'jlj mlnut(> 'm :t.>condH Wn:;L n/<<lIIf; l'lald I~):;t_cdy riJ~ht-."f-wny i1 distnllC:~ or TJILH!J fc~l I:henc:c '>f)l,th 5(, dp.J;rcc:> 0:; minulc>S J(). :,;('(:oJ1(ls r,ll l. nt ("jghl onuJcs "f) ~nid I ighl-of-way I n .Ii:.tnnl.e of ~7.6.S() f('ct..morl: or Ie::;:;, I.u 1.he intersectioll \.Ii Lh said 1'~1Sl line of L1le: West (Juarl(>r(W 1//,) of. TrrJrl 15" thC:llrr. rlllc St>uth II III lHIlCf' of '-12 20 feet !IltJrr- or It>r;:; t.o I.he l/orlhwcst corJ\(:r of I nt I jn Dloc/( 4 PIal of ~Pllf:rC!;t Est.:} I (!:t, ~wc"nlin!; La lh(' l'lnl nWJ'coI. n~ n~I'()rdctl hI .'lat Iloak 2/" n1 I'np,r. 21.5 of th~ ""Idic' Het.on's f)f Pain. Jlcnch LDllIlly, Flod<.J<l. thence Sout.h 89 l1cr.rc(~ 07 m.illllles 2:' sertJlllls F..lflt nJ(H1!~ tlte! Norlh }jrH' of ai,l lOI. / n c1i:;tnncc of l'iO 02 fcet to the intr.nwctiou "tit.h lhl~ \.Jr.~~'cJ'ly r'i,:IlI:.-uf-...ny line' uf Southcll:;L 1st Place. thence due llorlll lIoJln ~ajd ll,:,;(cTly l"ighl-uf-lIt1y / illr. n llist.Uler> of 297 79 feel ") lite intf!f"serl.iufI wilh lh," ';()lIlln'('~l.crly ri~"I--or-'\I;)Y Ijne or Snul:he8~t 7."], h ^vf'nun n:J :<;ho'WlI Oil 111(' Plnl uf (,n y 11nT ,.:: !.ulf's n1"on-:01I'III. j (,,,Ptl, ..heJlel: North It;'; lJ'~r.rcC'~ 58 minute:=; 1') ;e~(.fJlIll:l W{':;l aJ'm~ <mid <;olllhwosttJ,-ly rip,hl:-o(-Io'/lf line 0 IHsluu('c ur ]94 (,I) rC'ct to III angle puint 01\ ~mjtl ~onthwesterly rJght-of-WllY linej thence Nurlh .56 tlt:grc(!s OS mi "ul(~n 'J() RCCUllds WC'SI. illong s.dd Sou1.hwcstal"1y right-or-way J inn n disla'H:c of 4 Db fr.el. t.o the 1'0 illL uf Denifln.i fig nforcdcscd bed RECORDER'S MEMO: Legibility of document unsatistactOlY when received. documecl to be a true copy of the record in my office 18 FOURTH day of J NE,2001 Wl,J{EN, Clerk of cO.'u , Palm ach County, FL ,J L 'LC CO- (/U:L Deputy Clerk .F"~:\l Ct:Jt~""", I certlfy thlS oF ~.;-o~ 1:~'~ :~j''''YDq.\ {~/g ~lP;bOROTHY ~ 11 ~,l. ~ltt I ~ -0 \,"1, ~'!i! ! By ll.~'. -1- "'. of- ~" :AlCH ,,~f '" 8~ ....~_..~...' _..:' I'll, 1fCH CO ~~,,- \,\\\\\,,,,,,,.... ---~-- -~~-- va.lid unless sil'lned inu "-