HomeMy WebLinkAbout0021 iLA. tP07 LAWd ~T IIAMCOF01lM 1=Or !
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(~l~ttri~t ~t~n
~ St. Lucie -
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6efore ms, ths und~rsi9~ed suthority. P~~sonalhr- appear~d-....-.....~5?~C$@... w.• Cq!(1pt4n..... _ .
who, b~in~ duly swom, says thal h~ is tM lienor herein o? # # oF the lierwr he~an,
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4051...S ~....U... S....1--P.. _ O.~ Hox.. 1988......F't_.... Pierce Fla. °
whos~ addrsss is......
(lierwr s Add~sss)
and that in purwanos oF a contrad with..... ..~~?C.......~d15?~......~~dM!~?~'a_..G.a......~.i47,~.~na
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185~O...Pa].m...8each...H1xd.,...Stuar.t., . Fla. ~.3494 . _ :
lienor fumished labor, servioss o? materials oonsistin9 oF: (Deuribe specially fabricaled materials s~psralely)
j~tyCtE COtl~~~i~
105 Square Yards High Rise Carpet ~ RO~~~ ~n~ .
105 Square Yards 3/8 Pad RF~ D yER
fiED
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Installation
~t 31 tp ~ ~ ~75
~517
of a total value of.. _Five Httlzdred ~ev~t~ & 78/100 . _~~an (s _507. 78 ~
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of which thero remains unpaid S-. -_507~ 7g ,(or whidi amount he daims a lien on the following
described real PropsrtY in _ _ . _ St...--T.r1~~.~Q..._.. . _ . _ County, Fbr~da:
(Desuibe rea) property wfficienlly for identification, induding street and number if known) ~
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Lot 5 Block 3217, 334 Na~h East Orchid Dr., Pt. St. I,ucie, Fla. ~
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; ~ General....Development_.Corpcration_ _ ~
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Owned by . . .
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He fu~ther says that lienor Fumished the fi~st of said (abor, services or materials on.-..........- . ~
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~ ..........HSJY,.....2~?.e..........., 19~~.., a~ the last oF the same on • .............NQ~I......_~6,............, 1974.., and (if the lien ~
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is daimed by one not in privity with the owner~ that the lienor served his notice to awner on ~
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19 by- _ . . . _
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~ . . (Method oF Service) ~
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~ . Ke11er...Building.. Products_. of . i
T F't. Pierce, Inc. ~
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Sworn to and wbsaibsd bsfore ms this. `J ~ day oF- ~
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~ ?~OT~RY P1181IC. STAtE OF f10RIDA AT tARGB ry f
` MY CO?dMt ~
~ ~ SSiON EI(PIRES IAN. 22. 19A ~~1 b
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~ ,-1~/drrxs 4051 S. U S 1, Ft. Pierce 0 R
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