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HomeMy WebLinkAbout0023 FLA. IY67 LAWS 3,~2~2?~ j` IIAMGO fONM I10 ~ F8 71~09 (~l~ttnt ~f ~.~t~n ~ctc of ~toriax ~ ~outci~ of 8~fon n~ th~ unde~ ' nsd autlwrity. P~rsonally appeared . li(.J C~~ . ~9 tha ayent who, bein9 duly sworo, says that is th~ lienor herein or ~~~~y ~ of the lienor henin, ~ . (lieno~ s Name) . ~ D..._ ~ °k. .'i~.~-~ 1~.~~r,~'~ ~r~ .3s~s' whoss addreu u . . . , (Lierwr s A ~eu) - ~ ~ ~ C~C I~G~ and thst in purwanos oF a contrad with . . ~ . . ~~-~~'..."~L . , . . . _ . . li~nor fumished labor, serv~ces or materials oonsistiny of: (Describe :pecially fsbricated materisls s~psrately) ' / v I ~2 ~ 1 n ~ ~ n ~ ; ~..o~ .~l1 i ~ ~ ~ ~ r , ~u.~- ~e ~ fz~ ~ ~E ~C4~~tA Gfll POIiAAS ~ C! ERK CIR~~UIT GCI,~ - - ~•£:~c~~p ' 3?~~~~,~ J~~ I~ 3 z3 PH'11 : . p. , of a tdal value oF-.. . - . ~ ~ doUars (s ~O ) - of which thero rsmains unpaid s-`~ 9' ~ 6 for which amount he daims a lien o~ the Fdbwin9 ~ ~ desaibsd real propsrty in ~c. . . County, Florida: (Desuibs real prop~rty wF~iaently for identification, indudiny slreel and number iF known) _ ~ - . ~ - , ~ ~ ~ ~',t,~, 3 ~.~~P~~ ~ ~ ~ ; Tr~) ~o ~ c . E ~ 3~~' ~ • ~ / : ' - ~ . ~ ~ pM,,,sd by...... _ _ . . . _ . . . . . . ~ W~ fi~fl~er ys that lierwr fumishad the first of said (abor, services or materials on -~~'/~-~~f 7 ~ r ` _ q 19•~-.~, and the last of the same on _....._...~~~`-~....1! 19? and (iF the lien ' daimed by ons in pri ity with tha o r) thal t lienor served his notice t wner on . - ~ ~ • o ~ ~ ~(i~ ~c~ cti . _ j~(,t.~.- _ _ _ _ ~ . ~ (Method of ice) _ ` , u . . _ . : By . ~ Aqenr omey . ~ - ' ~ swom to and u,bs~~ed b.for. m. tl,a f.~j...~..........................day of ,9 7~ ~ ~ . . . . ~ c • ~ . . _ - . _ . _ _ . . . . _ - . ' Notsry Public 1 %u I~rsln~m~•~d ~?r~p~~n ~l l y: , . ~ . . <<?!e of F1a~;~ :D f~rlr~Itx~ . ' • ...:_t:~ t:~.-ises c..~c+~r . ~ - ,~-,s ~~•AcM+~M Fis a [siw~•i l ~ . ~ ~ ~~271 ~ ~3 : xi~s-.-~" ~ ~ _ - ~