HomeMy WebLinkAbout1201 .
~ Cei•tified Mail~#105902 ~~~"7
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Qtountp ot.....~T...LUCIE . :
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E ME the undersi ned authority, pcrsonally appeared ~
BEFOR , ~
...........................~C~A~3~..JAGK~Oi~I.-----------------._..._-•----•-----------------•------------------._._...---------............, who,
bc•in~ duly sworn, says that he is (~K~'t~o'~~X.+~ii) (tl~e [agent~ [~tb~itjj~j of the lienor herein) ~
wliosc addrrss is _~.2QQ__~1i~..l~Sth__S~~et-
P.O. Box t~z~6
----`_~lest Palm ~eacn~_.Fla,._3_3_4~7----------------------------------------------------------------------~
and tltat in pursuance o/ a contract with ~~~r-~es--Gr---lQnes-._Constxu~~is~n_.C~o_.---------------
P.O. Box 3341
------------------=-----------------------------•-------------------._V~xa._~eac~i.,-- F~,~-•-----------..._...-------------------------------------,
li~~~ior f:~rnished labor; services or materials consistin~ o~
1 p4~.~t-- $Xs ~~~4------._......-------------------------------------------------------------------....--
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(Drscribe specially fabricated niaterials separately)
on tlic f ollowing described real property in ------------aT.__.LC[~IE-----------------•-------------------------._...
' Co:utt~~, Florida ------SPA^ZISH__L~K~S:_ PHASE GNE -
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~ (Le al descri tion attacheci) ~
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E (Describe pro¢e~t~~ su f
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icientl~t f
or identi
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rcation and giae stree.t address i
f aaailable)
~ owrt~>d 61~ __t~ah1_J.~---H~~?__.~x~x~..2xxi[lPntal__.~S.Y~~~m_s__~_..Inc_.---------------------------------------------------
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~ o/ a total value of $----250Qa_QD of which there remains un¢aid 2~4~_.
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und furr~ished the first of the same on________________;I.u1.3~__bT__~._9?0._____., 19--...--- and the last o/ the
same on ------------------------slun~--~.Q~---------, 19__7_L_ and (i
f the lien is claimed 63~ one not in privity
with th~ oivner) that the lienor sesved his notice to owner on_________1u~.y.__~7______________, 19._~~. by
!herc d~sc~ibe method of service of notice).____.__..._.~er_tif_i.ed__Mail_.___~1~3.7_$1~
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~ uRIF_EIA.[._.;~iEL .~SI~T._C_~RY.08ATIODI._.(Fla )
~ Lienor
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~ .Sworn to and subscribed be/ore me this_._..21~t~.._.__._day o/ .............S~~G~~11~?~~....:;,~~. a,~,;'~•,;~
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~ tlf}~ C.'nrnmuston cx¢ires._. 'a ; ' L'.~. ' ;
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;ni:. Znsr.rurnent Yrepared by: . d~ pU
~ Clar~ Jackson
~ v. f3or. 8266 ~
~ I~s~im:~l~ec r:, Fl a. 3:1t'~7 l~E~~
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