HomeMy WebLinkAbout0154 r V• TUTBI.ANX tEGISTtilEU U. S. PAT. OFFICB
FORM IISr Claim Q! Li1eTl ~ T~tJ~ l.w h~~t lai.. Pd6~u Rad~w~, V~.
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I lE0 Ak• RfCOROE~ f
i~. `UCIE ~OUNit? FLA.
Siate af FLORIDA ~ ~tOCER POITAA:
11ECOR0 VER~FIEp~~~~,~~~
c~mu~tg af sT. LvciE ~ FE8 3~Q 23 ~N't1
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BEFOI~ ~VE, the u~~dersignedauthority, personallyappeared K. D!„ C~SSENS~,,,.,..,,_„_,,,,,
0 ~..aoX....6~.3....F.R~C.k..P.x~x~~,...~~o.~7.dd.~...3~~~Q who,
resid nt and A ent
being duly swo?n, says that he is ~ of the lienor herein)
whose nddress i~ .dA.d..Adi~~...].5:..... C„AS~S~NS...CZKQV~..S~I~.VIC.E....~NG......d..~~,R~x~.........
corpora~io~.... ~:...A.t..~4~....~t~.~ •...~R~~ ..~~4~~~g,...~:'~4~:~4~~~
and that in pursuance of a contract with ..~NAIrAN..RIVER..GI3AVE..CQM~~INY,...,a.~.1~DOx~~d........
3 ~ ...~a~Ft!~eX~~~4P..u~d~7C..~~~..~rlW~...Q~..~~...~QIR~iI?O~~ri~d~t.~i..S2~..~aS~~Gh~l~~~~~.....~~e
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~ Q ~ lie~ior furnished labor, seruices o~ materials consisting of ....].abO~C.,...aervieea...machin~e„~y.......
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~ Y (Descnbe specially fabncated matenals separately)
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z p a~ on the following deseribed real property in ...5 t,.,, Lucie
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~ count Flori ..tb.~..N~..o~..zh~..~i p~...khs..S. . and...t„h~..S. a~..itY~.~..5 A.~..the..
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~ " .N.~,:....a~l..in..S.ectimn...2B-%---the..N. o~..~.he..N. of..~he..S. of..the..west...3 4•
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~ the S'~ of the S~ of the N'~ of the West 3/4; of Section 27; all in
~ .~o~rn~~h~,R--.~4..~s~utb~....~tax~9~...~BE..~ask:... a].~,..~an~axmxmQ...~B~.~~~..aczesj...muo~r~..o
; (Describe property su,~ceently for identificatibn and gice street address if a~ailable) less;
~ owned by I~xAN..RIYEB.~RQ3l$S..CQMP~IY,...a..Limit~~d.P.ar~=sbi~.u~der...the..
~ Laws of the Commonwealth of Massachusetts,
~ of a total value of s.28.,S2~1...83 of whieh there remains unpaid 5..1.,.~9~...87..................
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~ and furnished the first of the same on ...............4T31J1~1d~y...~................., 19..~2~... nnd the last of the
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~ same on ~TaJ7~ua~}t..3.1 19.7.1.... and (if the lien is elaimed b one not in rivit
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~ ~ _ a copy of this Claim of Lien on the
~ with the owner) that the lienor served i~~ta~OiQx~t owner on .........,..~~~7ClJ.d.~y...#3....., 19.7.~r.... 6y
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irmail rti 'ed United S tes ail
- (liere deseribe method of sen;ice of notiee)
= Postage Prepaid, Return Receipt Requested; No Notice Of Intention To
~ File.. Claim of..Lien_.served,.on. owner.because,.of..privity. of..direct
x ~ -.'.~ontract with owner.:..
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~ • ';t.J ~ S~;''•;, . ' K. D C SENS
~ , AS , ~~XPresident and Ag nt
~ `^~I~~.~~%~. Of CASSENS GI~VE S~{RVI .~j,_ 'r i Lle r
whrn' to and subseribed be ore me this.. J~~ 1.
~ - = ~ ~ is ^ f ........day of....... ~E= 1~s3~J! .:.:~~~~~1~~'~rN~,~~r~~
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~ ~ Mr Cc.~:,.:s::~n Ex~res Sert. 2b, 1972 - r` •
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~ , , ..ll~y Commission expires p ; j• .r -
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