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~M+~ 21 8 sa AN 15
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B~fon n~, fh~ und~rsi~d au~hority. P~rsonally~ appsar~d .............J..i~l!A4a....J.... .~~llltbt.......:.......................... . ~
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who, bNn~ dulY swon+. says th~t h~ is ths lienor he~ein or ~ th~ attomsy S of the (i~nor her~in,
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...:.........~amaa._J..~...Smi#.h...d,,l.h,l.a...Du~a,.S~ans....~.o........................................................
~ (li~nor's Nams)
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~ ~....826...22nd Avenue,._..Varo_._Be.aah,~_..F1a.....32.9.b0 .
(lie~ s Addreu) i
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Edward Q. ridland s ~
. . .......St.......... G 4?~4 .Q...............
and that in pursuanoe of a oontrad with . ;
8......J~.....E......Indu~tr.ie.a . _ . . . , :
li~nor fixnishsd Isbo~, ssrvioes or materials oonsistin9 of: (Dsscribe speciallY fabricated materials s~parately)
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Labor and materisl for atucao and teatured coating.
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oE a faal ~slue of-...E]..exen..hundred_.s.e~rentg....ana--..-_-~.-,.~..della~s (S 1171,.00_ '
of which ths~e remains unpaid 5.-11'.71'00 for whid~ amount he daims a lien on 1he Fdbwin9
desaibed real Props~tY ~n......St.-....Luc.ie . _ .......County, Florida:
(Describe real propsrhr wffiaentt~? for identi6carion, indudiny street and number if known)
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! Lot 20, Block 199, SOUTH PORT ST LIICI$, Sec. 15
; Plat Book 16, Page !~2
; 187l~. ve s thaven
; Port St. Iucie, Fla.
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$ p~,,,ned by..._.Gr~~~~~1.....~oe.~o.Pment. .~.o.rP.-
Hs Eurther says that lienor fumished the first of said labor, services or materials on
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...........Iae~c...._.~ 19...~-ZL and the last of the same on ...~TA~~.....lQ..._......-----......_...., 19--7~, and (if the lien
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is daimed by ons ~w1 in privity with the owner) that the lienor served his notioe to owner on
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~ ..._....._D~~..,.....~.4........_........,19?~., by.......Mail .
~ ..(Method of Service)
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:x _ .............l~t~a~.a.-S~.o7~~....C.ct................._ .
~ ~ ~ L'°"°r '
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~ - ~ M or ~?rtomsy
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~ ~ SvYoFn •to and ~ubsa~sd before ~ this.......-....~. ~ ......................day of.. .~19~ 7~
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~ a.:?4~~ tG Notary Public
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~ MY e n ~1~ c~i~RiD• i ~RG?
~ • . . COMMISSION O(PIRES AAAY 9p, lyn
~ ` re ~j . dOtJDED THpU GENERAI INSURANCE UNDERWRI
~ ::~~~7.~r~,~~F P~ y~ aa~a$ a. s~?~th
.~3.. 826 2~
id Avenue ~ R
~ Vero Beach, Fla 32960 6G~K~5 PACfZi~
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