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CLAIM OF LIEN
STATE OF
COUNTY OF St. Lucie ~
BEFORE ME, the undersigned authority~ personally appeared
E. E. ROGERS, who, being duly sworn, says that he is (the lienor herein)
(the agent/ attorney of the lienor herein) whose addreas is
508 Colorado Avenue, Stuart, ~lorida, 334~4, a~d that in gursuance
of a contract with GEORGE T. WILLIAMS. Route l, Box 1180. Jenaen
~~~~h. Florida
lienor furnished labor, services or materials consisting of
Survevinq
(Describe specially fabricated materials separately
on the following described real property in St. Lucie
County, Florida: _Al ~ of i.~t 9. Block 4 and that o~rt of I.ot 15.
Block 3. East of U. S. # 1, in St. Lucie Gardens S/D., Plat Book
1. Paqe 35, St. Lucie County, Florida. ~
(Describe property sufficiently for identification and give street
address if available). ~d MICHAUD, his wife
owned by George T. Williams and JEAN A. WILLIAMS, his wife and/
for a total value of $ 928.60 , of which there remains unpaid
$ 928.60 and furnished the first of the same on Dec. 8 ,
197 1,.and the.last of the same on May 3 , 197 2 ,
and (if the lien is claimed by one not in privity with the owner),
that the lienor served his notice to owner on l" ,
197~_, by (here describe method of service o notice)
Revistered Mail
E. E. Rogers, enor
S~aorn to and subscribed before me this ~,iday of Ma '
.
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197 2 r,
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