HomeMy WebLinkAbout0233 ' Y~ / sw~eo ?owM ~sow
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a ared...~~IE L. HOLTON, SR. ~
~fon n~, +h~ t~d~:g~wd aufhorilY. P~rsona~lY ppe _ . . . . . . ~
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who. b~+nq dulY swo~n. ssYs IhN :w is fht INr: or herein ~ . . . . . . :
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TOMMIE L. HOLTON, SR., d/b/a HOLTON TRACTOR SERVICE ~
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(l'senor s Nsme) ~
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vrtws~ addrsss is......_..Z18....L~iidw.a~_.Raad.,....F~rt . Pierc.e, __Flor.ida...3.3.~SQ........_ . .
(Lie~wr s Address)
and that i~ ~ursuanos of s oontrad w~h..-~--...CONCRETE MODULAR SYSTEMS, INC. , ~
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li~nor h~ished labor, servio~s or ma~erials oonsistin9 of: (Deuribe specially fabricated ma~erials s~PaTatelY)
Complete landscaping and clean-up after construction crews.
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TEN THOUSAND...EIGHTY AND_98,~100.---~~an ~s 10,080.98-----~
of a total valus of....-..._........---~
' • 9~ 57 4. 04 for which amouM he daims a(ien or? the folbwing
of which there renwins url~aid . _ . .
~ -•---St-e.....~~Cle_.....- - . _ . . County, Florida:
described ro properhr in.........
~ ~p~ r~ ~~y ~y for idsNiEitatan, indudin9 street and number if known) ti
See description attached hereto and made a part ~
i hereof.
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~41`1~RETE MODULAR SYSTEMS t INC. i. . _ _ . _ ~
Owned br _
Hs huther says thst lisnor furnished the first of said labor, services or materials on - APrl-1. .17 ~
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197-~•, and tFee iast of the same on....~ug~tst.. 16....... 19~~-, and (if tke lien ~ ~
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a daaned by one not in privity with ths owner) that the iienor served his notice to owner on j in privity) ~
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. --~---•,19-----...., by . _ . _
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(Melhod of Service)
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° lienor
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By._.----- . ~ - .
Agent or Attomey
21s t Augus t 197 4
Sworn to and wbsan~d b~foro nw tha._ ..................~-•--••---....---.#-..r....day of ~
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- .S7tit~i.O~;.~~.., ~..~..~\S..~?.~t.-~ _ .
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. c~ Notary Public ~
- -j'r ~ J • iJ M in.yy 3
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'17,~~ I,u~rru„~,,, pm~u,x~! Gy: - o- - : - _ . 1.~..; c:...: :,~s..~s ; as. i~sr e
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i~t~(~/lYS /"s11V~,1 dl .,~lrrix•ii :is~`- :
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~ 0. BoX 3089 '~''~~~~~t""•• BOC+(~c~1 VA6E ~~3 ~
FOtt ~Ce, Florida 33~5Q
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