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TU'[BL~NX lEGI526=60 V. S. PAT. OFFICE
FORM llsr Ctaim c~ Lien =.,,M p.,., p..~:.~.. ..,~w.. ~
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f lE0 a;~;~ RECOR
f3tat~ of FLORIn~A ~ - s~ wciE couNtr ~t~i
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~O~~fl ?;IiRAS ~
C~EitK ~t~CtNT COURT
~Op1lZg Of PINELLAS ~ RfrORO V~~tFtFp,.~,~ `
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BEFORN: AIH:, the u?zdersigned uuthurit~, pe:sonally appeared ....David Browderr Jr .,~,,,ESC~. ~
who,
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beiiiR duly sworn, says that /se is (t1~e lienor herein) (the [ugent] [ottorrzey] vf the lienor he.rein) ~
ici~ose address is ..~?itehu~st.. t~. B~owdtir,...~i~~o~;~}eY~...~4t..~~!!....`~.~~.. ~`Ir...k'~
Harrison.,Avenue.s.,Clearwater.~..Florida....33515
and tliut in pursuance of u contract wiNi ...I~~.~:7~~~g~...V.~~~~$~..R~...V.~XR..~EdCh.~..~iC...........
lienor furnished labor, seroices or materials consesting vf ...FA9.l.A~£X'~Y~.~3..~Af~.. S1~X~~y.7,ilQ.........
~~o~e~.~~o~a~__$ex.y.~~e~,.._~y~~~~~~~i..by.,Ramsey._&..Associates_~Inc.,,and Brown
' ' a division of Ramse & Assoc'ates Inc.
.`~'~.S~~,A~..T,~dk?Q~~~9?4:a4.4'$ ...............................................Y....................~...........c....................---..._._...
(Describe specially fabrecated materiols separately)
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on the following described real property in ......,Sit....T.~UICi.~
, Cour~ty, Florida .T~;acts.. 9~1Q,,...~eS~.. $...~~X~$.. ~j~..~4aC~l~l~..~aCdCk..~...&..~.~SS.. `f+fest...10
' ~C~~~..~X?C~...~0....~~C.~~~OA._.7.1.....~niA....3.4..S~o.......Rg...38_._~,.__IHR?AN.:RI.V.ER..FARMS.
' COMPANY SUB.,ACCORDING TO I~P OR PLAT IN P.B.2, ~g 25, S+~. Lucie Co.,FLA
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i _ (Describe property su$~iciently for identification and gioe sheet add~ess if available)
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I owned l,y ......HERITAGE VILLAGE OF VER~..~.~C~~..~~C~
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of a total value o~S...74 , 858 . 46 , of whieh there remains unpaid a..14 , 582 . OS
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z and furnished the ferst of the same or~ ..NovemUer 9 1973..... and the lasl of the
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~ : same on .I~~~~X...1$ 19.75.... and (if the lien is elaimed by o~ie not in pricity `
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~ with the owner) that the lienor sen:ed his notice to owner on ........J~LId 19......... by
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~ (here describe metlzod of service of notice} n/a
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~ ' RAMS~Y ASSOC IATES , NC
t t(~~~.~~.~'L..~.~.~~. ~r.~ry~'~~.
` ~ Attorney for Lienor
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` ~ Sworn to and su~sa~~,et~.~befQrb.me this....~...........~y of
.............JanuarX..........., 19...76
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::...`-t:'!l.:tt~: ~:~t
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~ - ~ ~;y:ary P;~ix: Stst~cQ;:~r,~a ~i ~ (Notory P ~lic)
' , bft~ Commission expfrQS.~~:F`:~~~~ ~D'~~ 5! 1973 I
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