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BF'FORE AIE, the undersi~ned authority, personally appea~ed ~
Frank D. Camp.,__ Jr. ,..P.O. Box _ 215, Jensen Beach, __Fwho3~~~
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b~•in~ dul~~ sworie, says that he is (the lienor ho~ein) (t :
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ulios~ addrfss is ----------.1?..I...~I._.Rustic..~a.~ae~,...~~ms_e.A._~~.a~la,..~`l.._..3.~!+52 ~
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and that in pursuancc o( a contract with __~ohn__I,...Smi.th__..s~.nd__._Ada..M...~mith}_.Hi~- Wife,
li~~n~r /urnishc~d labor, sc~vices or matcrials consistin~ of
. .?"~tEl: ~Y_~ .:•.,:~DE~
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~ Des~ribe~ speciaJ!}' f ab~icated ~naterials se¢arately)
321..489
nn thc followin~ descsibed real propert3~ in St. _ I,uCie . `
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(.'ounh~, Florida ------TaQ~__~-.~F$--~--.I~-~---lxt._~b.~,t._~9](~S14I4~nium__known._as..OUTDGOR._RFSORTS
' QE_.AMEBSGA_AT__J~'~'T~LES--.ISI~AIJI2~,--.a,s_.rs~le~t~s~.__xxt__~Iat. B44k--~6__ at_..Page_..1: lA
' throu_gh__1J__in_ the_Public__Records of St. I,ucie Count~~__Florida.
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~ tD~scribe propert~~ sufficientl3~ /o~ identification and ~ive st~eet address if aaailable)
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i ou~~:c d b~' -------Sahn-.I~.-._Smi~h.-~d.--Ad~.--M. --Smith~_.His__]e1i~f.ei-----------------------------------------
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i o/ a total ualue o/ $------2~Q.QQ...--------•-------, o/ which there remnins unpaid $-----250.~JQ.------•----
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and /ttrnish~d the first o/ the same on----------------------•--------~------------------.., 19_7~.. and the last of the ,
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sanre~ on ______.._U~ct~___llth,___________________, 19_~; and (i/ the lien is claimed by one not in privit~~. ~i
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u~ith tk~ owncr) that the lieno~ serued his notice to owne~ on_________n/a _ '
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~ ifr~r~ ~Ir~s~sibe~ m~thod of seraice of notice~-----•--------•---------------•-•--...--~--•-----..._..----------•----------.._....-------
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~ Su~o~n to and subscribed before me rhis.___.~gt~_..__day of_.__.__Nauember 19--.75-• ~
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