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R04-135 II I 1 RESOLUTION NO. R04- ,35 2 3 A RESOLUTION OF THE CITY OF BOYNTON BEACH, 4 FLORIDA, AUTHORIZING AND DIRECTING 5 EXECUTION OF AN AGREEMENT FOR WATER 6 SERVICE OUTSIDE THE CITY LIMITS AND 7 COVENANT FOR ANNEXATION BETWEEN THE CITY 8 OF BOYNTON BEACH AND BARBARA CLAIBORNE; 9 AND PROVIDING AN EFFECTIVE DATE. 10 11 WHEREAS, the subject property is located at 1019 S. Ridge Road, Lake Worth, 12 Florida (Ridge Grove LT 27), outside of the City limits, but within our water and sewer 13 service area; and 14 WHEREAS, the parcel covered by this agreement includes a single-family home, 15 with cottage in rear, located in the San Castle/Ridge Grove project area; and 16 WHEREAS, only potable water is available for connection to the property at this 17 time due to recent water main improvements constructed by Palm Beach County as part of a 18 neighborhood improvement project;; and 19 WHEREAS, currently a water main exists on this street, allowing for service to this 20 parcel, and no additional construction will be required by the City to serve this property. 21 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF 22 THE CITY OF BOYNTON BEACH, FLORIDA, THAT: 23 Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed 24 as being true and correct and are hereby made a specific part of this Resolution upon 25 adoption hereof. 26 Section 2. The City Manager is hereby authorized and directed to execute a 27 Water Service Agreement between the City of Boynton Beach, Florida Barbara Claiborne, 28 which Agreement is attached hereto as Exhibit "A". 29 Section 3. This Resolution shall become effective immediately upon passage. S:\CA\RESO\Agreements\Water Service\Claiborne Water Service Agr.doc I I I Return to: (enclose self-addressed stamped envelope) ! Name Address: ,. _ r, r"- ~T: t11 n ~\ E :- ¡\CH 11'1111111111111111111 ~. \ 1 '~, t~~ <._ ~._- ~~' .. ::,\ ~:~ (-". r: 1 Ie'=-, CFN 2004052=1794 " Pt'i :: : G \ OR BK 17511 PG 0052 í' ('C? 23 RECORDED 09/15/20&4 13:52:06 C_I Palm Be-ach County, Florida Dorothy H Vilke-n, Cle-rk of Court Roa.¡ - 135 THIS INSTRUMENT PREPARED BY: {{~~: J ames A. Cherof, Esquire J osias & Goren, P .A. Office of the City Clerk 3099 East Commercial Blvd. City of Boynton Beach Suite 200 P. O. Box 310 Ft. Lauderdale, FL 33308 Boynton Beach, Florida 33425 AGREEMENT FOR WATER SERVICE OUTSIDE THE CITY LIMITS AND COVENANT FOR ANNEXATION THIS AGREE~N~tde on thi~ day of . , 20Q, by and between ~'4:ooc~ ~Jl.~ . - \~.. ~C~:;:- hereinafter .:alled the "Customer", and the CITY OF BOYNTON BEACH, a municipal corporation of the State of Florida, hereinafter called the "City". WHEREAS, Customer owns real property outside of the jurisdictional limits of the City of Boynton Beach, Florida; and WHEREAS, Customer has requested that the City of Boynton Beach, Florida provide water service to the property owned by Customer; and WHEREAS, the City of Boynton Beach has the ability to provide water service to Customer's property; and WHEREAS, the City of Boynton Beach has a policy which conditions the grant of water services outside of its jurisdictional limits on annexation of the property to be serviced into the City at the earliest practicable time. NOW THEREFORE, for and in consideration ofthe privilege of receiving water service from the Municipal Water System and the mutual covenants expressed herein, the City of Boynton Beach and the Customer, his heirs, successors and assigns, agree as follows: 1. The City agrees to provide Customer with water service from its Municipal Water System to service the real property described as follows and which Customer represents is owned by Customer: (Exhibit A) 2. The Customer and the City hereby agree that there are I. If+/. OEquivalent Residential Connections which City shall service. 3. The Customer agrees to pay all costs and fees of engineering, material, labor, installation and inspection of the facilities as required by the City of Boynton Beach Code of Ordinances or Land Development regulations to provide service to the Customer's premises. The Customer shall be responsible for installation in conformance with all codes, rules and regulations 1 Ii I 1 PASSED AND ADOPTED this ~ day of August, 2004. 2 3' CITY OF BOYNTON BEACH, FLORIDA 4: 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 I 20 I 21 I 22 23 24 I I I I I I I I I I I ¡ I I I i I I I I S:\CA\RESO\Agreements\Water Service\Claiborne Water Service Agr.doc i I I I \ I applicable to the installation and maintenance of water service lines upon the Customer's premises. All such lines shall be approved by the Director of Utilities and subject to inspection by the City Engineers. The City shall have the option of either requiring the Customer to perform the work necessary to conform the lines or the City may have the work performed on behalf ofthe Customer, in which case the Customer will pay in advance all estimated costs thereof. In the event the City has such work performed, the Customer will also advance such additional funds as may be necessary to pay the total actual costs incurred by the City. 4. Any water main extension made pursuant to this Agreement shall be used only by the Customer, unless written consent is granted by the City of Boynton Beach for other parties to connect. All connections shall be made in accordance with the Codes and regulations of Boynton Beach. 5. Title to all mains, extensions and other facilities extended from the City Water Distribution System to and including the metered service to Customer shall be vested in the City exclusively unless otherwise conveyed or abandoned to the property owner. 6. The Customer agrees to pay all charges, deposits and rates for service and equipment in connection with water service outside the City limits applicable under City Ordinances and rate schedules which are applicable which may be changed from time to time. 7. Any rights-of-way or easements necessary to accommodate the connections shall be provided by the Customer to the City. 8. The Customer shall, contemporaneously execute and deliver to the City an Irrevocable Special Power of Attorney granting to the City the power and authority to execute and advance on behalf of the Customer a voluntary petition for annexation. Customer covenants that it shall cooperate with the City and not raise opposition or challenge to such annexation if and when annexation is initiated. The property shall be subject to annexation at the option of the City at any time the property is eligible under any available means or method for annexation. Customer will inform any and all assigns or purchasers of any or part of this property of this covenant and of the irrevocable special power of attorney, but Customer's failure to provide such notice shall not constitute a defense or bar to the City's rights as set forth herein. The Customer acknowledges that the consideration of initially connecting to the City's water supply is sufficient to support the grant of the power of attorney any subsequent disconnection or lack of service shall in no way impair the power of attorney nor constitute a diminution or lack of consideration. 2 9. Annexation is intended to be and is hereby made a covenant running with the land described in paragraph 1 above. This Agreement and the power of attorney referenced herein is to be recorded in the Public Records of Palm Beach County, Florida, and the Customer and all subsequent transferee, grantees, heirs or assigns of Customer shall be binding on the Customer and all successors and assigns. 10. It is agreed that the City shall have no liability in the event there is a reduction, impairment or termination in water service to be provided under this Agreement due to any prohibitions, restrictions, limitations or requirements oflocal, regional, State or Federal agencies or other agencies having jurisdiction over such matters. Also, the City shall have no liability in the event there is a reduction, impairment or termination of water service due to acts of God, accidents, strikes, boycotts, blackouts, fire, earthquakes, other casualties or other circumstances beyond the City's reasonable control. 11. The Customer hereby agrees to indemnify, defend and hold harmless the City of Boynton Beach, Florida, its Mayor, Members of the City Commission, Officers, employees and agents (Both in their individual and official capacities) ITom and against all claims, damages, law suits and expenses including reasonable attorneys fees (whether or not incurred on appeal or in connection with post judgment collection) and costs rising out of or resulting ITom the Customer's obligation under or performance pursuant to this Agreement including disputes for breach of warranty of title. 12. No additional agreements or representations shall be binding on any of the parties hereto unless incorporated in this Agreement. No modifications or change in this Agreement shall be valid upon the parties unless in writing executed by the parties to be bound thereby. 13. The Customer warrants to the City that Customer holds legal and beneficial title to the property which is the subject of this Agreement. IN WITNESS WHEREOF, the parties hereto have set their hands and seals thi~ay of - ::::::r w \ '1 ,200~. WITNESS: ß INDIVIDUAL(S) AS OWNER(S): ~ \}~2~1 @,{d) .. L(JJ/7 .. Owner Signature --- Itness Signature .~~ rnV\J ~~À ~~~ ~~Q\~.~ ~~\f'P P nt~ Witness Name Printed Owner Name ~~j ~;~ . "- rO ¿ i-p- ' D D~ ¿?--.e-( . ···~I S~ Printed Witness Name 3 ~ ~Cµ_f - Owner Signature ~""""''-\:. ~(2...~ ~ ,~\~~'. ~vr-"-' Printed Owner Name Printed Witness Name FOR INDIVIDUAL (S) NOTARIZATION: STATE OF FLORIDA ) ) ss: COUNTY OF PALM BEACH) I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid in c the County, ~for.estd }o take acknowledgments, personally appeared c ~ " . XN n-Q....... to me known to be the person(s) described in and who executed the foregoing instrument that he/sheªcknowledged before .-' . --... me tha~ he/she exe~uted .the s~e; that te individual W~~llY known to.J!Ì'e or provided the followmg proof of IdentIficatIon: '_U. ~ESS my hand and O£fir sea! in the County an~ State last aforesaid this ~ day of ,J' \ ,200_.0 '. (Nota,<):,:!$.a!) '0" 00';' ~ C;,y;::o "4/7 e'/"'~;~ V"::'CMMISSION# DD039711 EXPIRES. ..' ""L- _¿ // ,...:" ..= JUly 10 2005 '~~~i:~'= ,r~J'''-"'' ".0' ;.IN 'N'''O'N(, iNC Notary Public 1'1 00:: p,.. _, _oJ - -.... ;--" ""ttll\" WITNESS: CITY.J)1îBOYNTO BEACH, FLORIDA /7l~Jw-- ~ ~ ;P~; ~ ' ~- STATE OF FLORIDA ) ) ss: COUNTY OF PALM BEACH) I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid and in the County aforesaid to take acknowledgments, personally appeared . Sè.:(l' ~ -<, Mayor and -Se..~ 0\. ~\-n.\~D , City Clerk respectivel of the Ci named in the foregoing agreement and that they severally acknowledged executing same in the presence of two subscribing witnesses freely and voluntarily under authority duly vested in them by said City and that the City seal affixed thereto is the true corporate seal affixed thereto is the true corporate seal of said City. ",L\ WITNESS my hand and official seal in the County and State last aforesaid this ~ day of ~'2IU'* ,200~ & ~ (Notary Seal) ~ Notary Public c)-tS'-v P(¡~(... Lola Bramwell : ~ ~ Commission # DD327683 ~~ ~ Expires June 9, 2008 CF "" _ TII!y '.11 . II'oIuIIInoo,lnc. 1IQO.38S.7D19 5 > THIS INSTRUMENT PREPARED BY: James A. Cherof, Esquire Josias & Goren, P.A. 3099 East Commercial Blvd. Suite 200 Fl Lauderdale, FL 33308 IRREVOCABLE SPECIAL POWER OF ATTORNEY (By Individuals) STATE OF FLORIDA COUNTY OF ~ ~\ \t'- ¿~ I/We~ ~ ~\ ~ ~ ~\~..... b~ hereinafter "Grantee", hereby make, constitute, and appoint THE CITY OF BOYNTON BEACH, FLORIDA, true and lawful attorney in fact for Grantee and in Grantee's name, place and stead, for the sole purpose of executing on behalf of Grantee the power to initiate, maintain, and complete a voluntary petition for annexation of the real property described herein into the CITY OF BOYNTON BEACH. This power shall extend to the CITY OF BOYNTON BEACH - full and complete authority to act on Grantee's behalf to accomplish annexation by any , , available means. The real property which is the subject of this power is described as follows: 00- Lf3-Lf~ -01 - O?f - CJCXJ - 02-70 , The powers and authority of my attorney, THE CITY OF BOYNTON BEACH, FLORIDA, shall commence and be in full force and effect on the ~ ~L- day of ..:J ) ~ '-" , 2OQ:L and the powers and authority shall be irrevocable by , Grantee. IN WITNESS WHEREOF, we have hereunto set our hands and seals the ~ day of ~ u \. , ' in the year two thousand and ~Ù~. Sealed and delivered in the presence of ~ -~~~~~ Owner Signature ~~\... ....~~ ~ _Q\~'\~~t"~ Printed Owner Name '-- Witness Signature Owner Signature Printed Witness Name Printed Owner Name Witness Signature Printed Witness Name S';A.TE OF FLORIDA ) ) ss: COUNTY OF PALM BEACH ) of 4t~fYç;::___ . . ~ Dana Davis ~ " ¡fti :*~ 'v:' ,.0MMISSION # DD039711 EXPIRES ;t:~~~~?,". July 10, 2005 ",P,f,,'è.,· .~·';b 'HRU .aov PAIN 1/I'UIi"'iC~ !NC Type or Print Name Commission No. My Commission Expires: POA.IND v 1890 , 68~ ~ 67C 166~ ~ 65CJ 164C 1622 1610 ~ 60(J 159~ ~58(J 1560 ..- 0 1 in. = 104.4 feet O· ~70CJ ~69( )68~ ~67~ ~66~ )65~ 0630 062C )61~ 060C )59CJ 0571 0660 BE~D~D 01 Z( 1030 N1( 0420 M4CJ )46C M6C 0470 0481 0491 )51 C 0520 )54~ ~55CJ ~ ~~~ ~~ S~ icl~~ ~ ir 00 ~ '.' .., r--. -----.::::: 1050 )40~ )39C 0370 )36( 0330 )32CJ )31( 0290 26( 00· I S R II." Rr OO! 1360 ~ )16CJ 0170 ~19Q 0200 0220 )24C 026CJ ~ <I 1661 tt 003 IZf ~ ~ 1660 := ~ - ~ - 016CJ 0130 ~12~ 0100 0080 b07CJ ~06CJ œ ~ 006C ~04CJ 0020 )01CJ > 3 ~ ""'" . ..MIHEii Rn MINERBD. I I I . ~ 1)021 ~O1( 0020 0010 , 0020 0010 0020 0010 0030 0040 ~ 0030 0040 0030 0040 ÞOS. ~04. I ~ »02. -O1( r< - Location Map - Exhibit "A" Lrt_ 'hH ~~ 7 , " <'~ . l~ o,r THIS INSTRUMENT PREPARED BY AND RETURN TO: Tammy L. Gindel UNITED TiTlE LAND SERVICES, INC. 1850 Forest Hill Boulevard West Palm Beach, Florida 33406 Property Appraisers Parcel Idenmicatlon (Folio) Numbers: 00-43-45-09-08-000-0270 Grantee SS t: SPAŒ ABOVE THIS LINE FOR RECORDING DATA THIS WARRANTY DEED, made the 22nd day of July, A.D. 2004 by SCOTT J. HEWITT, A SINGLE MAN, and DEAN C. MARTIN, A SINGLE MAN, herein called the grantors, to BARBARA A. CLAIBORNE whose post office address is 1019 SOUTH RIDGE ROAD, LAKE WORTH, FLORIDA 33462, hereinafter called the Grantae: (Wherever used her.in the terms "grantor" and ..grant.... inClude all the parties 10 Ihi, Inatrument and the heirs, legal represent alive. and assigns of individuals, and the successor. and a..igos 01 corporations) WIT N E SSE T H: That the grantors, for and in consideration of the sum of TEN AND 00/100'5 ($10.00) Dollars 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 duate in PALM BEACH County, State of Florida, viz: LOT 27, RIDGE GROVE, ACCORDING TO THE PLAT THEREOF ON FILE IN THE OFFICE OF THE CLERK OF THE CIRCUIT COURT IN AND FOR PALM BEACH COUNTY, FLORIDA, RECORDED IN PLAT BOOK 22, PAGE 8. Subject to easements, restrictions and reservations of record and to taxes for the year 2004 and thereafter. 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 grantors hereby covenant with said grantee that the grantors are lawfully seized of said land in fee simple; that the grantors have good right and lawful authority to sell and convey said land, and hereby warrant the tnle 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, 2004. IN WITNESS WHEREOF, the said grantors have signed and sealed these presents the day and year first above written. L.S. ~tk-~ ¿ltIhL LS. C. MARTIN 1019 SOUTH RIDGE ROAD, LAKE WORTH, FLORIDA 33462 STATE OF FLORIDA COUNTY OF PALM BEACH My Commission Expires: ...o,~~.Y. ~~"t- GARIL YNN ATCHLEY * ~ « MY COMMISSION I DO 239726 _, §>~ EXPIRES: Seplember 22, 2007 ""~or: F\.dl" Bonded Tho, 8udgetNoUI) S.rvlceS , F\I. # 24·20205 - I A. SETTLEMENT STATEMENT u.s. Department of Housing and Urtjan Development OMB No. 2502-<1265 B. TVDe of Loan 1. - FHA 2. - FmHA 3.. 1- Cony. Unln.. í 8. FlI. Numb., 7. loan Number 18. MO"gag. Insu<8nc' Ca.. Numb.r 4. - VA 5. - Conv. Ins. 24·21J205 3300418369 C. NOTE: This Ionn 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 information purposes and are not included in the totals. D. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender BARBARA A. CLAIBORNE SCOTT J. HEWITT BANK OF AHERI CA DEAN C. HARTIN 1019 SOUTH RIDGE ROAD 830 CENTRAl AVE lAKE WORTH, flORIDA 33462 1019 SOUTH RIDGE ROAD ST. PETERSBlI\G Fl 33701 lAKE WORTH, flORIDA 33462 G. Property Location H. Settlement Agent UNITED TITLE LAND SERVICES, INC. 1019 SOUTH RIDGE ROAD lAKE WORTH, flORIDA 33462 Place of Settlement I. Settlement 1850 Forest Hi 11 Bou1 evard Date Sui te 103 07/22/04 West P alII Beach, Flori da 33406 00:07/22/04 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller 101. Contract sales price 135.000.00 401. Contract sales price 135.000.00 102. PeffiOnalDroDertv 402. Personal property 103. Settlement charaes to borrower (line 1400) 4.533.96 403. 104. 404. 105. 405. Adiustments for items Daid bv seller in advance Adiustments for items Dãid bv seller in advance 106. C~yltown taxes to 406. Cityltown taxes . to 107. County taxes to 407. County taxes to 108. Assessments to 408. Assessments to 109. SWA 7/22/04 TO 10/01104 63.86 409. SWA 7/22/04 TO 10/01/04 63.86 110. 410. 111. 41 I. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 139.597.82 420. GROSS AMOUNT DUE TO SELLER 135,063.86 200. Amounts Paid Bv or In Behalf of Borrower 500. Reductions In Amount Due To Seller 201. Depos~ or earnest money 5.000.00 SO I. Excess Deposn (see instructions) 202. Princioalamount of new loanrs} 108,000.00 S02. Settlement chal"!les to seller nine 1400) 4.923.80 203. Existing loan(s) taken subiect to 503. Existing Ioanls) taken subject to 204. 504. Payoff of first mortgage loan 75.280.99 WELLS FARGO OOHE MORTGAGE 205. S05. Payoff of second mortaaae loan 206. 506. 207. 507. 208. S08. 209. S09. Adiustments for items unDaid bv seller Adjustments for items unDaid bv seller 210. cnv/town taxes to 510. Cityltown taxes to 21 I. County taxes 01101 to 07/22 421.40 51 I. County taxes 01/01 to 07122 421. 40 212. Assessments to 512. Assessments to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 5t8. 219. 519. I 220. TOTAl PAID BYIFOR BORROWER 113.421.40 520. TOTAL REDUCTION AMOUNT DUE SEllER 80.626.19 300. Cash At Settlement From or To Borrower 600. Cash At Settlement To or From Seller 301. Gross amount due from borrower (line 120) 139.597.8 2 601. Gross amount due to seller (line 420) 135,063.86 302. Less amounts paid by/for borrower (line 220) 113.421.4 o 602. Less reduction amount due seller (line 520) 80.626.19 303. CASH FROM BORROWER 26.176. 42 603. CASH TO SELLER 54.437.67 1 n7_?1_?004 ~t 1:Sfi PM RESPA, HB 4305.2 - REV. HUD-1 (3186) JEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT PAGE 2 ;).... SETTLEMENT CHARGES: FILE #: 24-20205 PAID FROM PAID FROM 700. TOTAL SALES/BROKER'S COMMISSION based on price $ @ = BORROWER'S SELLER'S Division of commission (line 700) as follows: FUNDS AT FUNDS AT 701. $ to SETTLEMENT SETTLEMENT 702. $ to 703. Commission paid at Settlement 704. 600. ITEMS PAYABLE IN CONNECTION WITH LOAN P.O.C. Items 601. Loan Origination Fee 1% BANK OF AMERICA 1.080.00 602. Loan Discount % BANK OF AMERI CA 84.24 603. Appraisal Fee to HOHEFOCUS SERVICES. LLC 24BB 604. Cred~ Report to EXPERIAN .60B 605. Lenders Inspection Fee to 606. Mtg. Ins. ApprlCation Fee to 607. Assumption Fee to 606. LENDER CLOSING ÆE BANK OF AMERI CA SOD .00 609. TAX SERVICE FEE HOHEFOCUS TAX SERV I CES. LLC 75.00 610. FLOOD CERT FEE TRANSAHERI CA FLOOD HAZARD CERT 11.00 611. 612. 613. 614. 615. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 07/22/04 to 06/01/04 @$ 17.01 /day 10 Days 170.10 902. Mortgage Insurance Premium for to 903. Hazard Insurance Premum for vrs to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance 3 mO.@$ 59.75 /mo. 179 .25 1002. Mortgage Insurance mO.@$ /mo. 1003. City Dro¡;;:¡; taxes mO.@$ /mo. tOO4. County propertY taxes 11 mo.@$ 66.54 Imo. 973.94 1005. Annual Assessments mO.@$ Imo. 1006. WINDSTORM INS. 3 mO.@$ 110.17 Imo. 330.51 1007. mo.@$ Imo. 1006. AGGREGATE ACCOUNTING ADJUSTMENT ·679.76 1100. TITLE CHARGES 1101. Settlement or closing fee to United Title Land Services. Inc. . 125.00 125.00 1102. Abstract or t~1e search to Uni ted Ti t 1 eland Servi ces. Inc. 125 . 00 1103. Title examination to United Title Land Services. Inc. 75.00 ·1104. Tnle insurance binder to 1105. Document preparation to 1106. Notarv fees to 1107. Attornev's fees to (includes above ~ems No: ) 1108. Tnle insurance to United Title Land Services. Inc. 395.00 750.00 (includes above ~ems No: ) 1109. Lender's coverage $ 106.000.00 395.00 incl 25 Risk Prell 1110. Owner's coverage $ 135.000.00 __u 750.00 1111. ALTA 6. 6.1/R50 United Title Land Services. Inc. 70.00 1112. FL FORM 9 Uni ted Ti t 1 eland Servi ces. Inc. 100.00 1113. COURIER FEE United Title Land Services. Inc. 30.00 30.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees Deed $ 10.60 ; Mortgaoe $ 240.10 ; Releases $ 250 . 70 1202. C~y/county/stamps Deed $ ; Mortgage $ 1203. State tax/stamps Deed $ 945 . 00 ; Mortgage $ 376.00 378.00 945 . 00 1204. Intangible Tax· 216.00 1205. RELEASE FEE TO UNITED TITLE 25.00 1300. ADDITIONAL SETTLEMENT CHARGES 1301. SUlYev to LANDTECH SURVEY! NG 245.00 1302. Pest insoectioo to 1303. WATER CONNECTION THE CITY OF BOYNTON BEACH 2.473.80 1304. CONNECT WATER HffiR 60B BROOKS PLlMBING 375.00 1305. 1306. 1307. 1308. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 and 502, Sections J and K) 4.533.96 4,923.80 . .r YtN orrower ~ . . .r tatement which 1 have prepared Is a ~rue a.nd accurate account 0 the funda which were received ~d have te.n settlement of Ihh. transaction_ J ~ ~ J- ~ 0'1 WARNING: It is a crime to kn~wlngiy make lalse sfa'eme Date to the United Slates on this or any other similar form. Penalties upon conviction can include a fine and imprisonment. For details 88e: Title 16 U.S. Code Section 1001 and Section 1010. ()7_?1_?M.4 ,:¡t 1'<;1; PM RESPA, HB 4305.2 - REV. HUD-1 (3/86) ......---- A. SETTLEMENT STATEMENT u.s. Department of Housing and Urtjan Development OMS No. 2502-0265 B. Type of Loan 1. - FHA 2. - FmHA 3. l Cony. Unln... 8. File Number 7. loan Number 8. Mortgage Insurance <¡au Number 4. - VA 5. - Cony. Ins. 24·20205 3300418369 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 information purposes and are not included in the totals. O. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender BARBARA A. CLAIBORNE SCOTT J. HEWITT BANK OF AMERICA DEAN C. HARTl N 1019 SOUTH RIDGE ROAD 830 CENTRAL AVE lAKE WORTH. FLORIDA 33462 1019 SOUTH RIDGE ROAD ST. PETERSBURG FL 33701 lAKE WORTH. FLORIDA 33462 G. Property Location H. Settlement Agent UNITED TITLE LAND SERVICES, INC. 1019 SOUTH RIDGE ROAD lAKE WORTH. FLORIDA 33462 Place of Settlement I. Settlement 1850 Forest Hill Boulevard Date Suite 103 07/22/04 West Palm Beach. Florida 33406 00:07/22/04 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller 101. Contract sales price 135.000.00 401. Contract sales price 135,000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower (line 14oo) 4.533.96 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adiustments for items Daid by seller in advance 106. City/town taxes to 406. City/town taxes to 107. County taxes to 407. County taxes to 108. Assessments to 408. Assessments to 109. SWA 7/22/04 TO 10/01/04 63.86 409. SWA 7/22/04 TO 10/01/04 63.86 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 139.597.82 420. GROSS AMOUNT DUE TO SELLER 135.063.86 200. Amounts Paid Bv or In Behalf of Borrower 500. Reductions In Amount Due To Seller 201. Deposit or earnest money 5.000.00 501. Excess Deposit (see instructions) 202. Principal amount of new loan(s) 108.000.00 502. Settlement charges to seller (line 14oo) 4.923.80 203. Existing loan(s} taken subject to 503. Existing loan(s} taken subject to 204. 504. Payoff of first mortgage loan 75.280.99 WELLS FARGO HOME MORTGAGE --- .... .. _ ~ -' __ ~ J __ _ _ _ 1___ JEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT PAGE 2 .... SETTLEMENT CHARGES: FILE #: 24·20205 PAID FROM PAID FROM 700. TOTAL SALES/BROKER'S COMMISSION based on price $ @ = BORROWER'S SELLER'S Division of commission (line 700) as follows: FUNDS AT FUNDS AT 701. $ to SETTLEMENT SETTLEMENT 702. $ to 703. Commission paid at Settlement 704. 800. ITEMS PAYABLE IN CONNECTION WITH LOAN P.O.C. Items 801. Loan Origination Fee 1% BANK OF AMERICA 1.080.00 802. Loan Discount % BANK OF AMERICA 84.24 803. Appraisal Fee to HOHEFOCUS SERVICES. llC 248B 804. Credit Report to EXPERIAN .80B 805. Lender's Inspection Fee to 806. Mtg. Ins. Application Fee to 807. Assumption Fee to 808. LENDER CLOSING FEE BANK OF AMERICA 500.00 809. TAX SERVICE FEE HOME FOCUS TAX SERVICES. LLC 75.00 810. FLOOD CERT FEE TRANSAMERICA FLOOD HAZARD CERT 11.00 811. 812. 813. 814. 815. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from 07/22/04 to 08/01/04 @$ 17.01 /day 10 Days 170.10 902. Mortgage Insurance Premium for to 903. Hazard Insurance Premium for yrs to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance 3 mo.@$ 59.75 /mo. 179.25 1002. Mortgage Insurance mO.@$ /mo. 1003. City property taxes mO.@$ /mo. 1004. County property taxes 11 mO.@$ 88.54 /mo. 973.94 1005. Annual Assessments mO.@$ /mo. 1006. WI NDSTORM INS. 3 mO.@$ 110.17 /mo. 330.51 1007. mo.@$ /mo. 1008. AGGREGATE ACCOUNTING ADJUSTMENT -679.78 1100. TITLE CHARGES 1101. Settlement or closing fee to United Title land Services. Inc. 125.00 125.00 1102. Abstract or title search to United Title Land Services. Inc. 125.00 1103. Title examination to United Title Land Services. Inc. 75.00 1104. Title insurance binder to 1105. Document preparation to 1106. Notary fees to 1107. Attorney's fees to (includes above items No: ) 111'\0 T:+I.... :......................._ 6- 11_':"'_,1 T.....'_ I ..._~ ("__....___ T__ ......... ...^ -..- -- O~o.. '" IÝa.,;f¡... 101'1 .r ¡!\rÆ¡~ ~ L4-4,,-,- h JJÝb'L- TO: APPLICANTS FOR WATER SERVICE OUTSIDE THE CITY LIMITS (SINGLE F AMIL Y HOMES) FROM: CITY OF BOYNTON BEACH UTILITIES DEPARTMENT RE: WATER SERVICE AGREEMENTS 1. Please sign the agreement (on p. 3) and the Power of Attorney form 2. Have your signatures witnessed and notarized 3. Attach a survey and legal description (LABELED EXHIBIT A), or provide the property control number. 4. Provide the name and address information requested below. 5. Return all documents to this office. NOTE THAT OUR OFFICE WILL NEED AT LEAST ONE WEEK'S REVIEW TIME TO PROCESS THIS APPLICATION, PRIOR TO US SCHEDULING IT FOR THE CITY COMMISSION MEETING. THE TIME SCHEDULE IS THEREFORE AT LEAST 3-4 WEEKS FROM DATE OF SUBMITTAL TO DATE OF APPROVAL, DEPENDING UPON THE ACTUAL DATES FOR COMMISSION MEETINGS. (THE COMMISSION MEETS ON THE 1 ST AND 3RD TUESDAY OF EVERY MONTH) Sincerely Peter V. Mazzella OO~©~OW~[þ) Deputy Director of Utilities JUl 2 3 2004 Owner Information BOYNTON BEACH UTILITIES Owner'sN~~~ ~\~\·~O\~ Mailing Address: p (') ~ ï:>X ,;,),(os-' ~\Lo WÛ~~~ ~ ~~y~ò No. & Street City State Zip Code Telephone No. stot. S::K':2.. 8CfrC;> Provertv Information: Address: -1'0 \ ~ ~o~ Q\ &~ \(J. Lp..~þ' V'\~ F l 3,34 <.02- No. & Street \ City State Zip Code Property Control Number (PCN) Do L ~ Y S- 0 î eJ3 ðbtJ O.2ìD