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fLA 141b7 LAV?'S ~ 11AMC0 FORM 120N
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f3eFore me, the undersiynod autho~ity, personally appearoc~ _ ~ ~C ILazzola
who, bein9 duly sworn, says that he is the lienor herein or ~he agent o{ the lienor herein,
~ tt~n~iGtrcey ~
Ra.mond,Bui?din_ Su p~. Cor div. - Florida Door Com an
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(Lienor's Name) P+:ail s P.O. BOX
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' 33dB
whose address ~s .1314 r~..Ta»ia~fi.. Tr. ~ I~. Ft, l~~yers, . F1~. .33903 ,
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(lienor's Address)
'i - ~ E.J. & E. Industries (Edward G.
; and Ihat in pursuanco of a contraci wdh _ .
Cridland)
, lionar furnished ~.~e~jCtLi1''4[ materials consistiny of: (Describe spetially (abricated materials soparatelyj
Doors, trim and hardware -
of a to~a! value oFTwo Hutldred '1't,~etlty Five & 85~100 dollars (S~ 225~85 )
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o( which ~here remains unpaid S~~5~85 , ior which amount he daims a lien on ihe following i
' described rea1 prope~ry in St. LuCie County, Florida:
(~escribe real prope~ty sufficiently For identification, including street and numbar if known) -
' ' Lot 21 Block 199
fILED l.M^ P.£C'vFDEO
I Port St. Lucie sub-divieion sT-~~~~~ "~AS ~
i CLERr ~:,;CiJkt CQURT ~
St. Zucie County, Florida vFr r,~~ ~
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~ Owned by G~ner~.l Develo??men~ Corp. , 1111 S, Aaysne~^.e _pr. , T~~~.~~,: ~'la ~ ~
33131 ;
H~ further says thai IiQnor (urnished the (irst of said j'~~~~7t5~,t~3pr materials on ~
Dec. lb . =
~ . 19-~4., and the last oi the same on DeC... 16 _ 197~ , and (~F the lien
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is claim~d by one not in privity v.~th the owner) that the lienor ser~ed his notice to ow~er on ' '
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~ '.~z~~~:~r~'..;'0,.... t9 7.5, by Certified mail - rAturn receipt ~
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~ (Melhod of Servicei ?
Ra~nnond BuildinU SuFply Corp.
~ div. - .Flor~,da. Daor C.orapany
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~ Lienor
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~ Agent $ I~X?~t~nY~ I
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~ a. :~~iw ~t~to ~r~1Y{ub~cribed l~ofore ma ~his . _ . . 2.?rid.. _ ...day oF JanUarY 19 ?S .
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~ ; i':~ Ft. :~~yers, F1a. 33>0 3 B
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