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(Na1M of Lie1Ior)
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(Re.ridence M Business Address of Lienor)
being duly swont IfI.YS that in I*rS1UlPKe of a contrtUt will. .S....L...lU.c_r.tl~P..._.:..__............
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. (HarM of Lienors Employn M person with whom he contttICted) -
} {labor aM }
he {Pfu1:::1 lhe foUowing urvic~s tmd (Hnl"tlucribe 1M laIxw or snvices J:n/Of'ffUd M
mtJIerials. <'
m41erials furnished. Describe s/Hcially fabrlcattld m41ni4ls seFately) ...-................--..-...............
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Section 29. Tnshp. )6. R&ftge 40 tb.nce s. 0 18')0 E. aloDG the Ea.t l1n.
..~.tl...:.!.~.~..~!~~(~cm...n.........j1J.ft..m;......9.(..1065A.2g...t:J.it.......~U.~...J....3.9.~l..!.1Q.~.. w.. t a
u .~.nc. ot ~20 teet t. a point ot curvat.reJ thence we.terly along'th. arc
ot a circular curve to the r1sht baYlftft a redS.. et 2020 te.t and a .
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..... ~ ..i....I-...ee...~... '-f.-et',""1;bo-ftc..-tf..-t ~ct ~. ....fl....-..IMa.....t:.. ! 11. 20
. tter . a polllt or .rvatur, tllence ort. e. t.erlv along -Ule arc ot a
..!t..r.~.1t ..r...cJttYA..1......t.h&.. r l O_t. ~...ba.1t.........rad.1U..~..iJ.~...aaC.a..A..ntn.l....ng 18 or
(contln.ed on back) f
to the value of .......-.$221..00...--.......-............................................... ........._..........-..._...._...~......
(State colllrtICt price)
on the following described real FOpmy. (Descrili4t,..#ItOperty suliciently fM idmtificalion, giv-
ing street and number if known) : ...f'.!'.\...$.l.tJ..wg.!!...W!.~~~l~!....~~!.~~~..._..._.....
.., ..~J.-....Y.lat.a..J...J.l!1tla.g..U.r..aL.....Par..t....sL..LaC.a....n.......P..lar"......l.1U'.l1la......
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owned by...P.ft.\..St.-..Lw:.1a.....t laM1.n.. Claar.cl4...1.Dc.....-.-.....-...-...-....-......-..-..-....
(Name of oumn "gailul wltose interest lien iscl4imed)
h. . h -, . _el'
W ose Interest 1ft sue few In'Olerty u.........-..-..-.........-............-..-..-.-...-..........-.........-....-....
(SiGle ounter', ;,unUl, (IS fee sim,ze, life e~ate, leasf-hold, if kMum)
H. further !tJ'Y' IMlIM l4Il il.... of {~.Zu } -{ 7:'=t} Oft IM,..15~.IL_-.....-
dq:y of...............~.MI..f.~-._.__., 19.-'1, ad, of 1M cOJllracl flricI stated, there is U7lJHlid
1M Qmount of .......-....$22.1...QO........-........... ...----...-..........-.. ..-..-...-....-....-..-.......-...........
(Slale "mount ""paid)
fM which amount he cltsims " lien ens the real 'fOperly herein d,urilHd.
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Subscnbed aM SWMll 10 belMs nu this.....f....~...... .....day 0 '';l'" ..~....<;'".'...,.'""'.;,i 19~~. ....
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