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HomeMy WebLinkAbout0129 / ~ ' fLA. IKf LAMf~ ' ~ ~ ~MCO FORM f~OM ~ F1 W.O~1 IN ~i~i~rit ~'t~ert ~ ~ ~ ~lowd~ of ST. LTiCIE _ } Bcfa~ n», tiw undsrsi~d horitY. Pe Ztiimmie...L....Holton,... Sr......._.. . sut rsonally appesrtd who, b~in~ duly sworn• ssys thal h~ is th~ lianor herain or ~~~N~li~dr~~1~ • ~ Tonnnie L. Holton, Sr. d/b/a HOLTON TRACTOR SERVICE . (li~nor s Nsms) 718 Midway Road, Fort Pierce, Florida 33450 ' whose add~rsu is . (lierior's I?ddress) and that in ~wwanoe of a oootrod with..._....CONCI2ETE_.MODULAR...SYSTEMS.....INC. . _ _ . . - . , . li~nor fumishsd labor. servioss or msterials consistiry of: (Describe special~Y (abricated materials s~p~uAtalY) Complete Landscaping and c~ean up after construction crews. of a tdal value oF...-Ten_.Thousand-Eighty. ~11d....98/100.--.-~la?s (S- 10~080.98 oF wfud~ there remains unpaid ;..-.4_,.574., Q.~._ for whid~ amount he daims a lien on thc fdbwing described rea! prope~ly in-....... . St.....Lucie- . . . _ . _ ...County, Florida: (Describe real property wfficientlY for identificatwn, inciuding s~reel and number if known) I . ~ "See attached description" ~ CONCRETE._ MODULAR_ SYSTEMS. _ INC.-. ~ owned by ~ ~ He fwiher says that lienor fumished tha first oF said labor, services or materials an~ -~P~~~- 17 ~ 19...7..4, and the last oF the same on.....August....16th---_...., 19.74~ a~d (if tha lien is daimed by one nd in privity with the ownerj that ihe lienor served his notice to owner on - ` ~_..c..r~.~. .`~~1........ _ . _ . . -...._.--•--_..__........__....._....__.........,19........, by . . . (Method of Service) . • p . ~'{.~...~,~.~...Q~_ . . . . . - u~ a : _ : = - _ y . . ..~u~,K?~ ':.A~ : g - ~~y ` i•~I~ is* ~ i ~~M ~ /'N~~~~ . • . . r,, i i - ; • r~t. _ ~ - ~ . . ~ . . ~ i . . Swom tcE ~nd~~~ ct~ ~ tlris 20 th......_ ....................day oF ugu~ t - - _ 19 ~ 4 . _ ' - - ~ r_~ : ~ ~ ~ ~ I ~ ' ~~~1~1, ~ , ~f~*~~~ . , • \ ~ • _ , . : O ~ i ~ ~A ~..YA^-.~.1. ~ . ~ _ ~ • " ' 2 ` ' . • • ~ Nota P~lic •K ~ i. t~.v ~~j~C~t C: . ~ ~^r~ P~. r. _ -tt `r ' ~ J' ~.f l~-'~Ml ~1 3 , U k ~ ~~~~tlltl~~'~ ~Qa~ 1>. Cw':r..•s<:.-n L.~,iccs f~S. i4, 1977 1 ` ~ ~ ~'~31 12~ , ; . _ . ~ B.. w.. t ~ _ , . ~~`-_,i - _ _ ~ - : . _ _ - _ . . . __:v~ .