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flOlIDA STATUlIS
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q. LUCIE C8~NTY, FLA.
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. - (Name of Lienor) "",;,," ~ ) ",."".
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__' ..__..m....?~~__.~g.~.~..~~~.~.L.~.~.~...~~.~.!;.~~ L.~~.?~ida ' .' J .,:..
(Residence or Business A ddre~~'~i'ii;~'~';')'"''''''''''''''''''''''''''''''''''''''''''''
being duly sworn says that in pursuance of a contract with .....W~~~h~~.P...J.~&~!;'~'~!'~"'''''hh..m.
€taim of litn
~t a Ie of. h.." __ .'WKlD.A... .............. h................ ...}
qro un tp of...... .~~.~m.~~.~~~.............. .........m....... ".
._ .e__ .___... ..----.- ...-........--------..................--........---.................... ..--...--...............................-.........-........................................................... ...
(Name of Lienor's Employer or person with whom he contracted)
{ f d } {labOr and }
he Pf~~:~~:d the following seruic~s and (Here describe the labor ()t' services performed or
matenals
materials fumished. Describe specially fabricated materials separately) .....,.........M(J1S..........
furnished labor and materials
, '........... ............. ....---...... .............. ..........., ............ ..... .......... .......... ......................f1tEO..ANO.~ECOROEO...
.' ................,............ -................. ................... h......... .......... ................... ...... --... iN .~~~..~
. ~...... -,..,.,.... -,................................................................... ....... ..h...'................ ..Ig~t... 'Affi.t3 "'AM" 9':"2~'
,...................................... ................. .......................--. ....,.......... h__...........__....... R-D -&E.R. f frlf flA. r:.. !':.I~::I(..
ST. LUCIE COUNTY. FlO~'iD't
...................... h.......................................................... --..... --...... --... --.......... --.... ............. ........... .-.................. ~
tot he value of..._... ~_~~...~~.~~.;:~~..~.~y-~~.~.~...~. ~~..~~~...? ~l.~.<?~...~~::'.~:~.~:::::~~.~.!~~!.~... .....
(State contract price)
on tre following described real property. (Describe real property sufficiently for idefltificatioH, giv-
ing street and number if known) :......~~...P.~.~~.__<?t..~h-.~__~.~~~...~Q9....;~~~...~~...~~~.......,..
. ..... ~.' ~... ~\..J :yJ~.&.. ~~.~.~__.<?~...Y.~...IJ.1...~~.~ ..~.~~.~... ~J. .9.~~~.~rr..p.;:~p~~.~i,.......m........
.,. ~........., .1)': ~~S. __ ~~... ~ ~~.;. ~~~.. .~.?.!... ~.<?~.~ ~.~P. ..~~...~ ~~ ~ ~"... ~~~~.. .~.~.. ~.~~.~."-..................,.
own ed by.............W !.~ ~ ~~~'p'__}:~g~~.~. ~ J~.......... ... m.....................__.m................ ............. ....:.. .h..........
(Name of owner against whose interest lien is claimed)
wh ose in t ('Test in sue Ii real property is.. .....J.~~...'.tmP.l~.................. ..................................................
(State owner's interest, as fee simple, life estate, lease-hold, if known)
{labor } {P f d } '. '3 d
H., f h 'h h" f. er ;Jrmt th r
. ( urt cr sa)s t at t e .ast Item 0 serVlc~s was furnished on e...mm....................
matenals
day of.._....M~J:~h.............m............m...' 19..~J., and, of the contract price stated, there is unpaid
t he a moun t of., ...Six. .Hun.o,'X'e.d. ..Seventy. ..Six. .ami.. 5.5/1QO.~~.":".~:-:,.~~.,,:,,.~o.Ql.la.r.ft. ..............
(State amount unpaid)
1M which amaunt hr claims a lien an the rca~~~~~e~~~~.,mnnnnmn
(Signature ,,/ Lienor
Subscribed and swarn to befnre ~ne thiLn~.:" n ~~"n"... " ..n.
NotaryP c)
..' 0'" - J,,__/", /loA L ... .........S.t......Luci.e..................F.1Qn.dA.................
/.<:!; .CO~?~Jsio'1f,.;:'(Pires...v?,,4~.. .../..J;./f/rJ. ,(County) (State)
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