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HomeMy WebLinkAbout0630 F~A71 ~ lAW )(,1 ~ ~ 11AMC0 IORM Ii0 M i5 /b<7t l . , ~l.~t'tx~t ~f ~'t~ert . ~ . ~ ~ ~ ~ _ ~ 8~ion m~. t1N ia~d~si~d au~i~orilY. Pe~sonslly app~ar~d S the a9ent t • - who, bMnp ddY swom, ssys ~hN h~ is th~ lie~or herain or of th~ ii~nor Mrein, . ~ th~ attomey ~ , U - ~.........~!~?j!~~ St~~......... . (~•s ~l - . ~dd~.~ 0~'` ~ ~d x ~o P~t~« 3.?ti ~ , _................................r - (lienor's Addreu) - • p~ • .r'w~~1.,.._ ........................t.'.~l~.~~yi~Y. _ and that m oF s ooMrad w~l~ s' S . . . . . _ , ~ar (urnish~d labor, sKVio~s or ~rials coesistin9 of: (Osscrib~ spscially fsbricsted materiab_ s~ps~at~ly~ ~ 6E0 - f~~p R!Kt ~£t~ 3nd~it eC /c 1'N~ 3~ i~v9 ~ S'{. ~tlGf :.O~IIITV Fll~ ~ ItQG~~ ~UiTR~S CLERi~ C2~tCWT COflRT • ~G y~(rj~jitL_ . . RfC4AD VE° iF1EQ ~ - - ~e 2b 9 si ~M'76 - ~ - 328233 of a total va{ue oF......._.. . _ ._.....doAars (s-_.....:. . . of .which thsre remains unpaid ~.._.a..~~...~.~~ for which amount he daims a lie~ on the FoHowin~ ' S-~ l ~~iz L'o . . _ d.sa~ibed real propKty in_....._....._....' -Coumy, fiorida: (Oesuib~ ~eal prop~rty w~iaed~Y For ideNification, indudin9 sheel a~d number if known) . ~ ~`i ~ o~~ v -t f ~ ~ o-~ z ~ /t/crti~ ~/.t/~ Q~` ~6I o a/fc ifl E a,e Aiiv~ ~ o .~1~? vr•.A ~eve aE~o _ . o"~ ~!X iE/7NO st~~ t~/v! Sio~~ .4ccv,ca~~~ ' '7~~ ~ ~i( f /1jl•U'!~,' ~`~Q J~ ~EuKOf~ !s~ ~EE~ ~ e / ~ ~ ~~G~ yo 3 ~ o-~ ~ /vh• c ~ ~co~vs ~ . ,L ~ c ~ L ~ ~4 ~,~y ~i~.~,~ ownsd b~,..---...~f_i~..~c:s_...._..l.t,,l.~~l.,~r.ra~....... st~~~.:r..-..... ~w~..._.....5~.~........vif~~-~r~_......~/y.~r.~ ~ ~f ~ s w~`~ - ~ li~ further says tt~at lienor (umishad ths ~irst of said labor, services or materials on~ .....................__.................,19........., and the last of the same on ..-............:................_.........._.._--.-.19-.----..., and (if the lien is daiimsd by ons no1 in privily with the owner) ~Fiat ths lienor served F~ notice to ownsr on , .............................~..._..................,19........., by..................... . _ . ~ ~,u?~t (Me of Serv' ) . . a~a~-8%o/Q8-ooo/3 ? . . . _ . . . . . . . . . ~ u.~« ~ ~ Br- _ . . ~ ~?~6M O~ /~f10rMy . - ~ Swom to and wbsa~d b~fore rrN this......~-~ ......................._.day of. c-"..l-~~.. ._....:..19~f~• ~ ~ ~ttt:l4Nifl/~, • ~ ~ . ~ ^P.. ~~~i~ k~ . 4i~- ~ ~ CAAI~ISSION ~E Ai RO?IpA AT IARCk ~ ~ - • ~ ~i~ eoHDED r+n ~ ,-s °m~a ~ xi. ta'f0 .~'~i:.. . , - . e4t r~.r.._ .....e r •-.....s~T~ " i'- ~ 0 Z, ~•'-':v L. d • _ _ • . _~.-~.y; - _ : - ~ ~ ~ • ~ f :;L- ~ Tlrin c~r~nm~~u~ prrprrrr~f by: - _ ;.:~:-Yp ~ . ~ - ~s ~s. - ) ~ A[/~/rXT ' . 4?~ T~~~~s• ~~i~. ~~i~:,~~~•'~`•' ~ Q~ ~ . _ u ~ ~ J>>~~i~,:,~,~~+..` ` ' Q~~~ ~u , . . ~ - ~ _ _..y. ._~ra ,.~oF'~~~'"{r~'~ ,~~a-- ~ - , . . . ~ _ `r . r'" . _ _ . . . - ~ .~Y~'~~'..J.:~ . _ . . _ ~