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C LAIM GF LISN 2 0 7 0 2 9
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State of ,~^i
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County of ' ' ^ ~ e
Before ~ee, the undereigned authorit~, peraonal~jr appearsd
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the agent of the lienor herein xhose addre es ia p. i~?
i~ r~ e, o_~ i3= , and that in purauance o~ a cont,ract
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lienor furnished labor, servicea or m~teriala conaisting of '`~'~~'"P ~
~•~~.al ~ '•a J~S -L ~ •-~r' ;''s ~n`~ ^i
on the folloving deacribed real property ia 5 t• j~~y~ CouritT9 ~
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r$ ~Wned by I 1.~..~ ~~'~Y1 i' } -~.l
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¢ of a total value of $ = , - ~ , oi xhich there rasains
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~ unpaid $ , ' ~ . ? and furniahed Lhe firat af t~s
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~ sa~ne on r , 19~_ , and the laat o! ttu ~
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~ sawe an r~'- J j„~ , 19~1 , and (if the Iien ie #
~ claimcd by one not in pri~?ity r~rith the rnmer) that the lienor aerved hia aotics to }
~ awner on i~.:=~ s 19= i v , b7
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RINKER MATERULS CORPORATI
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~ SWOrn to arzd subscrib bafore as
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