HomeMy WebLinkAbout1224 qO~IOA STAMii Vi`~~~~ OtiW'S ~OtM Y 1~01~5 !!V. '~i Y~whtlwN ~N I« NN N TM N. ~ W. Orti GwNw
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BEFORE ME; the undersigned authority, pessonally appea~ed Wm. J.:...~ S semer
.gre~~~.d~xl~...Q~..$A~dX..~~Bhtweig,ht..Roofin~..'~..SuP.~i1~t..Inc. who,
being duly sworn, says that he is (the liereo~ herein) (the [agent~ [attorney] of the lienor herein)
whose address is ......P-.-..0_:-.Hoz..l~.R~.-•--..~ensen__~3each-:---Fla.
.
• • Construction
and that rn pu~suance of a cont~act unth ~QJ~I._~r~.~~.3i
liereor fu~nished labor, se~vices or materials consisting of ....._N..an~ails,...~r~d..~~~i.x~...._._..
~ Q~nR~._e.~~ _.w ~~h_. hendr
a,i 1 s
(Describe specially f
abricated materials separately)
on the following described ~eal p~operty in ------St~.._Lucie--------------------------------------------------------------
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Counry, Ftorida -----t~_=
j!4~C'~~~-~-----------------------...------....--------.......-----........-----------------------......----...._.
,
(Describe propert~~ suf
ficiently ~or identi/ication and give st~eet addreu if available)
~ ~u~J..----~-A-~~----------------
owned b~~ _~~se~?~---~.~---L-~~-•---.~lJ~_......d~.A~~}----~
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~ of a total aalue of $.__,~~3~._.4~ of which the~e remains unpaid $_.~$~x~-4_.._______.__..
and furnished the first of the same on.._.___~lay...2~______________________________, 19._.7.~_ and the last of the
~ same on ----._S~,tne...12-----------------------------, 19_7_5--- and (if the lien is claimed by one not in priuit~r;:.," `
~
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with the owner) that the lienor se~ved his notice to owner on..._.~une_..1~__________________ 1~`~.~-s6y r,''.~ ~
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(here describe method of se~vice~of not:ce) Cer~_~~~.ec~ i~~~________________________________~ : d d' d~'~ rt
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- -----------------------------------------------------------'Bend_..-Li.._._..~e...._ht Roofing~~$~' t}PR ~ 4
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5 Sworn to and subscribed before me this......~......_____day of___.._ ae~t~m~.er 19_.~~__.
~
• •
1~~~ (Notury Public)
A1 y Commission expe~es -
voi~mr PUBUC. STAIE of FLORItk: ~t U1R6E '
MY COMMiSS10N EXPiRES APR. 7. 1976 ~ Cii.,7ar• •
dONDED iHRU ~EMERAL INSl1fLV~'.CE t3KDEKWKi1f~ ,!`~1, ~G~
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