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Home My WebLink About0701 ~ f FLA. 1967 LAWi 41'~042 ~ QAMGO ~011M 1lO~Y Fi 71,.OA t~l~tim ~rf ~t~~t ~ . a~~q ~ s T- ~~t ~u ~ BsFor~ m~, ths undsrsi~~sd authorih. Personally appeared...._.......:.~.......• - who, beir~ duly swwn, says that he is the (ienor herein or ~~he ayent ~ of the lienor herein, the aftorney ~ ~ . . _ . _ _ (Lienor s Name) : _ . ~ _ . . _ , . _ . _ , . _ whose address is - . - ~ ; ~ _ _ . _ , (lienor's Addross) • . , . : . , . . . . _ and thal in pursuanoe of a contrad with........ _ ' - . . . n. . . • ' • . . . _ . . „ ! . . . . . _ . . _ . . ~ . lierwr fumished labor, ssrvioes or materials oonsisting of: (Describe specially Fabriwted rinaterials separately) _ _ _ , , of a total value of.......... - _ _ _ dollars (S ' ) r• of which there remains unpaid S ' , Ior which amount he daims a lien on 1he fdlowing ~ dascribed real PropsrfY in _ . _ . _ ' ~ County, Florida: (Dexribe real property sufFidently For identification, induding street and number if known) , - , ~ _ . _ _ ~ . , . - . fjLEe R~v kt.Lai,z~ i'• WC:f :4!lMTr f~ ~ F~~i~F J!);~~LS ' n. ~ ~ ' . . ' ~1~2 s: ~ i~ I~ s2 ~N ~~p~ _ - . Ownsd by . . _ . _ . _ . He further says that (ienor Fumished the first of said labor, services or matarials on ! _ , 19........., and the (ast of the same on . . . 19 ~ . and (iF the lien . is daimed by one nof in priv'ity with the owner) ihat the lienor served his notice +o uwner on _ _ . . - 19-......., by.... _ _ _ , . . - : ,(~Aef of Serv~ ` / . ~.t :i . ~ _ lienor ~ ; , By _ j _ . _ . . / `L4yenf or Attorney ~ ~ ~ ,`~~~~IIIH~nh~~~, ~ ~ ~ Swom to and subscn'bsd bsfore ms this ....................................day oF .~.J?~~~~W~;;~•~, i ' r. ...y " i ~ : t Q,~• . - V = ~ . . , . Gc ~ = , , : _ _ . . . . ~ Notary Public ~ ~ ~ . ' ~ , ,:4J " : ~ . - , , . . ~ - '•~w~~..~, ~ : %%ii.c 1~~~/niinrid f~rrft~tr•l %y: ~Altr'~1~~•SrAtf ~tORrO~ ~4RCw . , Sl/jr~ 0~ ` / ~ ~~OOV~~~~+thJE'~.~iRES ~uG. ~ iy~~ .'Ir/t/R« C ~ ,~1( tCGt° i,~ ~O~Xltr ~~FkAJ ~.N i', ~ r,~S ~ ~o ~1• ~ ;~o<<G %y•.,, ~ ~ 7 u Rs~]~ . ~ ~ ~ r s ~1 9JJI(f~~ PAt~ ~ L - - - - - - ; 2 `r - z~~ ~ ~ ,s, ~w~~-,.~=~ . ~r~~~.:~,~~:~ ~ . . . . > _ ~s~~~~'~~~~`~~". a'!