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HomeMy WebLinkAbout0731 4~~~81 I ru? »n Mcc~u?w~cs~ RAMCO FORiN 120?4 ucw ~~w. rs naa ~ ~ ~l~ttm ~a i ~ _ . } ~ _ . _ : 8stor~ me. tM undersign~d outhait~r. p~nonally app~u~d ~.!...:..t'.::~`.:. `.1:. . who, beiny duly swor~, says that h~ is th~ li~no? h~~sin w th~ a~e~t of th~ lienor har~in, ~ . , ......~.:.~-s.;.:~.:.:...:•... . ' n.....:.y:-..=~. .u......-'.h a _ . _ + t~....._~~.:._ ~ l...L ~ (Usnor's N~me! whoss add~sss is ~ `.~.i s ~ i ! 2~. x' ' r _ . . (L~enor's Addr~ss) ~ , ~'..::.tiilc:L.~,:. ....P ~.r„ , •1 - ' snd that in pursuancs oi a co~t~act wiih......~....:_:..... ~ ~......~:.~.-~.........,~...jr.,,..z,.,y..... . 7 ~~r . . lienor furnished labor, s~rvic~s w mat~risls consistin~ of: (O~scrib~ sp~cially fabricated mat~rials sepa~atsly) ~ . _ ,..._ii' •_i:, :'1:..'_--. ' - i_~ ~ ~~0~?_ 1. - ':i _ . ~ • ~ . . . ~ k ' - « . 1 _ . i _ ~ ~ 1 1 - , ~ _ . . ~ ~ . _ . . . . on iM folbwing describsd real prope?ty in........:1...~.:.'.:~.:.:; ..........................................•----............Cou~ty. Florida: - , (Describe real prope~ty suNiciently ior identification, including street and_number, it known) „ _ . , ~ _ . - ~ ~ i.. C ; ~ - - , owned by . . . . . , - • ~ . - , of a total value of dollars ofwhichthereremainsunpaidS...-....•--~••-- ---•~~•-~~--~--~--•~~--••••-~•-~•~.forwhichamountheclaimsalienontheabove described real property. ~ 'f He further says that lienor fumishsd ths firot oi ssid labor, services w materials on ~ ~ _ . ~ ..19.....:...., snd the last oi the sam~ on---.-•-.....:..;.::...::::............. , 79........... and (if the lien s is claimed by one not in privit~? with the ownerl thst the lienor ssnreA h~s notice to owner on : ...............~~-~---......19...:...:... by..... , (Method of Senrice) - and, (if the lien is claimed by ons not in privity with ths contractor) that tt» lienw served a copy oi his notics to ~ ~ . ; owner on ~ • . (Contractor) - on.. .............................................19........... by.............................._...--~-•-~-~-~------.....-~---.............. , ` _ (Mathod of Ssrvice) and additionally, (if ths lisn is clsimsd by one not in privit~r with ths wbcontractor) that the lienor s~rved a copy of his notics to owne~ on ` • ISubconvactor) ; ~ ~ ' on......... ...................r;x,t~:.:,:~~...E:~CQt~.II~.D- . 9_.........by......................._...................-•-.....•----- • ~ 1 ' . _ : ~ U': ~ v, F ~ : . (Method of Ssrvicel ~ ~ 4~6;~81 t ~ ~ ~ , ' ~ - ~ '7~ ~ 6 ~~1 9 : y Z . ue~~ . ~ ~ ' er:~..._. . . . . ~ . - s ..A~snt _ . ' . . ~ _ - - ~ t':t_~:<.•-• • _ - _ _ ~"^P.yUQ_ ' y?, ,~-'7:h.._ ' - 8wom to and subscnbed b~fore ms this.____ -.day _ " ~ ' ~ ~ . 19..,~:.~. • ~ , . ~ : : : ' 1"~ r. •r. - r-..•;; : . . . - ~ , ti . r. ~ • ;`~'~`~t'... ~ i~:.: . ~ . ~ . _ . , Notary Public ,,-.f Th~is /ns~rum~~nt pr~parPd by: '~~-~ol' i~or~~ell .~j~ ~ A~tdrrs.s :~ixi_e T'irh•rt~:.y, .~tuar~ r'L 33494 ~~~,x~~ r'A~.~ ~t~~ _:_,a - ""~.y , ' - - - - - ` ~ g " _ ,r ~ - - e-;~ _ ,