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ST. IUCIE COUNTY. Fl~• 11 - - -- ~'`` ''
~l~m of ~~en ROGEft °QfT~;.1S.Clt"`;
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-.~_ ~~: , ~:_~;;.::+!_ .....-•---------• ................Name of Lienor)......_.......----------•-•--..........~.......----•------•------
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-Y° •~` • •,,' '~+~,~ ~.~ ~. _ 1 Soiltl! Narlat •~o._~_ Pt.P3aro~,Plorlda
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• - 'o~'•• ''•'' " ~ ~,~ (Residence or Business Address of Lienor)
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• ~ y pu f OL J - aDtaBS2
~~ fiei~~•du7~n sa s that to rsuance o a contract with ~A-_...........~ .................
...,,...•t•
- (Name of Lienor's Employer or person with whom he contracted)
performed labor and
he { }the following sesvices and (Here describe the labor or serrrices performed or
furnished materials
materials furnished. Describe specially fabricated materials separately) ............................................
Patirloat loa-- ~etd__ ia4t~ll~t ioa_ .of-_ dgot--rorY--lor--air _ Condit lonia~•_-._____.__
roorini. i'!~~u. ~*r.no~~..~~~!..-..._.ps.Ual*.lus..upl0.alt._.xi~.s~.~a~~ct~........
to the value of _.__Suzan.~nadl~sa_.Tlul..ald..'~.Q/.101~t.....«?.1Q.S.Q1--~?A~llarl--- --- ----
(State contract price)
on the f oUowing described real property. (Describe real property sufficiently f or identi fication, gia-
ing street and number if known) ______________________~$~..$47.s-1._~11~..~~i..~.sp~l~.:~11~
(So~tlt ..~..1!1F..Ax._~~..3,_..amt..~~...s~~..~x...4,...a~.~~,k._9_,._.~URF~IDR._UII~._ Qom,..---
as por plilt tluroo! rsoor0,od la Plat Boot 10 at pads 17, Pablio Booorbs
owned by.___•--------- Ors'~--~.--~atzta.~ad._lialana_-~...Sa~sei,_.~tii..nifit--------------------
(Name of owner against whose interest lien is claimed )
whose interest rn such real property u.._......!~-. ~~13 ..............
(State owner's intsrest, as fee simply, life estate, leose-hold, i f knoum )
• SOT f performed
He further says that the last item of sehriees was furnuhed } on the._..._~,?_~~1 .............
materials
da o ~~ '
y f------- ~-t--------------•-•-•-•---------,19-- -, and, of the contract puce stated, there u unpaid
the amount,-of..~l[ax1..Bl~dZA1~.~an.sad._S.Q/.a.QA~t..~~~.Q~~Q.~...-..A9tlas~ral..-..-..-
~' ~~-'~ " , „~',. (State amount unpaid) -
t~,tN~~.~u, ,~~ ~.~,
,. f fir: ~(~l~ stnet• he claims a lien on the rtal pro esty herein described.
,, -. ~ • ~~ ~.. r,, ~ :,.f; ~[J, t~i ~j ~t 91' ~ ~.7 ~ t°~ Q ~ (S=gnature O f Lsenor)
_ ~,' ''' v ~~~~ trAi~a to bsf ore ou this... s --...day o f -- ..I~tb~aal'j..... 19.
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" ,, ~ ..• (Not ublic)
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Co. d N.
My .~rtmission expires ~ M~!!~! ... ~'ounty) (Stata )
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