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ilOflOiA {iA1YTl~ ~~~4~,3 OlEW'f IOlM Y 178K t[Y. '~.l M~~~t~tbr~~r~~`~~~~~i~A:;~wr N.O~lli~--1~ ~ R~CORn VERIFt~O ~ . ~99383 ~ ~(~11 Of ~tleti s • 0 ocT ~ iz . ~e s ~ ~ttlif Of.......F~•~•~=:i.:::. ~ZOGER aOiTRA$ ~ CLERK CIRCUlT COUR'n ~ountp of...=: ~ e ! ~ 1 BF.FORE AiF., thc undcrsigncd authorit~~, personall~~ appcar~d t ' . . . ~ . . ^ L } ^ ' ~ . ^l yl'r R ~l~i n ~ -li• J ~ . 1 . . , . ~ . ~ . . ~ ~ . \.C•~ ~~'_'1~".T~ ~.l\. ~ wlro, bcir:t~ dt~lt' su~orn, sa}•s that h~• is (thF liPnor I?c~rc~in )(th~,,~~,~~r~~r~~~,~9f~t~~+~~~tqf;~h'f~pi~) , . : ~ • - ` t11~ ~ ~ ~ ~i , i1 ht~, r `1 ~ ~ . u~hose• addre•ss is ` . • ' • , . . _ ~ _ ~ - - • i ~ ___._.._._...__.'_._._.._'___..._._.-.._....____._._....__~__.'__._.....__.__._..7 , '~r • --`~,,n ^ -1-1.--~~~c- ~~.\-.1-R~'`.- ~ ' ' .i . _ ''..a ~ arr thQt in llIlT3ZlQTJCf Of Q!'Ori1TQf1 2l~]tI! ----•-~-~---`------r=•-•----...--••--•-••--•-------------•----•-•-••--•.._..----•----.....- ~ _ . - , - C':,:,e r-~ - .l . > > • _ . li~rior f urnish~d labo~, scrvice~s ov m4tPrials consistin~ o/ ' ' _ ,1 - i _ _ r , , . . a -n . ~ . , , . . , ~ ~ ~ ~ ~ _ . .'.t . _ . . _ : L . t • - , • . ~ ~ ~ . , .f'.. _ (.:~~_..~n~'f?.'i ~ _.r. i 1 V~ t"~.e .t~ ~ ~ ~ . ~t- t - -:l _ l ~ ~ ~ 1~_. ~ - - - - -""C.""""""""• • - - - - ; Dcscri6c sp~ciall~• fa6ricat~d matcrials scparatPl~~) ,~1'^~ ~ _ - _ ~ ~ on thi f ollowin~ dcscribcd seal propert)' ~ ~ 1rTl~~ ili~r ~ 1 ' ~ n • ~ _ ~ ~ r Tl Y ~ . _ . _ _ _ _ . „ _ . : ; :ountt' on a . _ ` , - - - - - , - - ~ : : . , ~ , ~ D~s~ribr~ p:opP~ty suf ficir~ntly Jo~ identifi~ntion and ~iae street add~ess if available; - - „ . _ - - _ „ ou•n~~d b~' " ' ' . : : _ - _ ~ of a total aalue o1 of which there semains unpaid and lurnished th~ first of thc samc on---:~-=-------- ------~-w-~=------------------, 19--•----- and th~ last oJ th~ samf on :^:-•-.------i---~ ~9-------- and (i/ the lien is claimed b~~ onP not iR priiittit u~ith thc ourner; that tlte lienor serUCd his notice to owner on...::~:.x___.6________________________ l9..=:~. by ' !h~re desc~ibc~ mcthod o~ seruiee of notice~-------------------------------------------------•------------•-----•-----•--------•-- , : ` ..-~----------------------~-f~_u_~ h_f_.._.~~~?~.__r:~.~:.~~-~~?---~c.. ."__~.~~--wM.i~~wT ._~4,~]~. ` Lienor b t . ~'01.@I' ' Su~o~n to and subscribed befo.e nre thiJ ....................day of_._..__...._...----- 19.-------• ~./-~j ; ~ ' 11~~.1.:~J.~.~~.~~~~~L..~2 ~ ~ (Nota~y Pu6tic)---- _ fii.xrion expires.._~::...::..._ -:;-~-~..1~-•-?---.. . ; - . - = ~~,T~n i; y~' : ~~~~~ri'.~ . ~ t`~;<<,: , :p ~ B ~ i8? ~i5~3 . r; . v~;. - _ . . . . ~ ~ _ _ _ ~ _ - 6, c ; y . ' _ •c.~~ ~ _ t