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HomeMy WebLinkAbout0319 F~w. ~ae~ ~wws ~ ~ 11AMC0 /ORM ~~r ~;.~fi~~t)lI ~l~tim ~t~n ~ ~ . ~ ; ~ aa~~ ~ .\~~c.~~ ; Q ~ B~For~ m~, th~ undersiynsd authorily, pe~sonally appeared ~-~//~~r~% l/• i . ~ who, be+n9 duly sworn, says that hs is the (ienor herein or ~ the~ a~~ ~ o( ths lienor herein, ~ ; : . . . _ .~'.lC~~....1. ~i..~~..r .Y,~'"!!~..~. " _ _ . . . . . . . . _ _ . (lisnor s Name) / _ ~hose ac~ess is . ~.?~~~.......[~!r'"/[ ..~`5-~_ • ~ ~r'6G.J.'~~.. • , (lienor's Addrsss) and that in purwanos of a oontrad wi~h L,~1`//~f ...~~~~5./~.'.GL'~T/lif/ ~ , .~/~iG~ - s- ~ ~ ? ~ ~ , ~ L~~!//~.-~,G J,? ' - Sr.~'~iG . (ianor fumished labor, ~rvioes or materials consisting of: (Describe specially Fabricated ma?eriak s~parately) LEi' ANu ~~ECCkaEO ~ ~ /Ci~/%/•! ~ /'-•k`r~~L%5 .CA//,'i~ t~y~E ~.;uNtr FtA. E A3CE= Fv17Ra$ a r C1~=~ COURT R!^'jR~ YE?~~,F~ ~ S~t 1~ 4 a4 PN 'T 6 3~E~~~C~~~ i ~ of a total value oF. v..~--`J /~G~. ---"~ollars (s ) L} ~~CtJ ~ of which there remains unpaid S~ , for which amount he daims a lien on the folbwing described rsal PropsrtY _;~(J~/G County,- Flo.ida: (Describe ~aal property sufFiaeMly for identification, induding street artd number if known) ~/C ~ ~ ~?PfU1i'd!~`S s " 1 •1 ~ i ,~C.pC~i~ iF~ ~~t=.r ` ~.x - S"/C~' ~ ' ~ ~ ~ \ v~c-t E U~G' ~ i ~Z ~ ~ 'L~9/3/'~/~ii~ti' ~ - ; ~ : - ; o~,ed by /...-i.~'~'/l~ . ~'_/~~G~` -T _~~-.~T,rS~c/G'~ l~>iLl _ _ - , ' Hs further says tha? (ienor fumished the first of said labor, services or materials on J~~y _ ; ~ ~ / . _ . . ~ ~ 19~1..; and the last oF the same on .....~.llliJ 19~~, and (if the (ien ~ j is daimed by one nd in privity with the owner) that the lienor served his nolice to owner on . _ , ; 19 by . _ (Method of Servite) : - ; ; (.,f,~L'lC~~ ~ll',r.~/T/rl..~~, ..G.l~~ ' lienor - - - _ .`y ~'l vy ~l~~~ ` y. 1 ~Nh~ ~ti ~ ~ A9em or ~ff y . , - . ~ j ~ j, • ` ~ ~ ` 9 ~.J . . . ......day of . ~ g.~~. Swom fo and wbsaribed bsfors m~ fhis ` . _ / ~ j ~1,. - . ~ . fl~~. s ; ~ r . ~v:~~ , ° , . ~ . ~ .r; ~ _ ~ • . , ~ • . ' ~ ~ e ~ K ` Norory fubit. S~aN ef fbrW~ ~1 lwf~ ~ 11'~/~-~-,1.~~. ~ " = ~ . _ _ , :t- - i ~II~ CanTiuion EsPir~s J~I 1~ - ~ • : ~ . . ~ t . . lendcd bY A^'•~:cor. fir~ b C•~so•dt• ~o IC t .s+ . . ~ ~j'~'/~~r-~~~ %liti /r?Un~r~iri~/ ~~rr~~,~ii~~l l .1 J~lr,:,.~ ~y'~'~.Si ~~C %C!%G'G :5~./~, R . EeoK25$ PAGE 315