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~l~t'tln ~af ~i`t~en ~
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d~Fon m~, th~ ~?~n~d authoritY. P~rsonally appear~d _ . .
' 11~ a9enf
who. b~in~ dW~r swom, says thsl h~ is th~ lienor herein or ~ 1h~ attornsy ~ of the (i~nor hK~in,
~
..............................................~.QIfl~14~~....I.~,~.....~~Q,t~A................. . ~
(li«wr~s Name)
M?ho~. addreu ~-.........]..~~9...~~dm....Axe.~~a., For.t _Pier.ce,....F1.........~.345.Q._...._. .
(Li~nor
s Add~eu) '
and Ihat ie pursuana of s oonhsd wi~h ._A-~S?l~... CQ~St~'L~~.t~,~lCA.... _ _
. . .
li~nor himi.shsd labor, servioes or materials oonsistin9 of: (Deuribe speaally Fsbricated materials s~p~sratelr)
Run water service line, install hose. bibba and tub.
Run seWer line, fureish and install all tixturss. ~
of a taal vakie of..._nin+G...hundr.ed._tvent~t ....._.._.dollars (s_ 9~4..OQ...
of whid~ there remains unpaid S__ 4.2Q•.00. f~: ~lsid~ amounl he daims a lien on ths fdbwin9
descr~sd mal property ie..........._ ..........................St.--. Luci+e......... _ . ..CountY. Flortdb:
(Destribs real propsriy suffiaently for identification, induding street and number if known)
5~~ ST~IIDICI'~ OU
TY fl~.
Lot 3, block 199 7 Port St. Lucie ~~.EPK~C~,cuis couar
RECOR^ YF31r1ED~~~
; ~ S~ 5 I i Zs AH'75 ~
3~~0- .s'/~ /339 - ~oo ~ 31615
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~ pwned by ..............._Genersl...Devnlcpement . . . _ .
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He further says that lienor Fumished the 6rst~oF said (abor, services or mate~ials on-..._
......................~!'1.~..Y._............._.., 19.7.~., and the last oF the same on...........,~U~ly......._....................., 19~.~, and (iF the lien
by one not in prndy wrth the owner) t t t (ienw serve his notice to owner on
is daaned ' ' .
--._..Jt~1.X2~ .............._........,19.7.5.., by......_ . .....statemeat.. .me~iled.... _ . . . . . _
(Method of Service)
_ . ........~!....~'j . . .
lienor
~ gy _ _ . . . ,
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~ A9em or An r
.
Swom to and wbsv~bsd before ms tha. . day of . _ . t~.j~.~ti~.,:, ~
~ ~ 1~ r: = I~~~~
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Notary PuDnc. State ot F1or10a ~t LarN - ~ ~ _
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My 6ommission Lxp"~ns Nov. 29. 197d Nolary Public _
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