HomeMy WebLinkAbout2193 FLA. IY67 LAW8 'Tll~Vu 11AMC0I011M 120r .
F8 718.00 PQ'{,`Y •
(~l~tim inn
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Before me, the undersigned authority, Personally appear sd ..!~1~"'' ~ .
the .a ent c
who, being duly sworn, says that he is the lienor herein or ~ the attorney S of the lienor herein,
.....h..o.~t.A..~.........f ~R. .n/~
..y _ _ .
(I.ienor s Name)
whose address is_.....~~.y...~.-... 4.'.-..?..A.~-... A /-d/~ T.S~....~-.v..~-' ~ . /
(Lienor snAddrLess)
and that in pursuance of a contras with ~ ~ 4F!- ~fi'~..~~ .9 ~/r.~ L~ l? _
lisnor furnished labor, services or materials consisting of: (Describe specially fabricated materials separately)
ST lUC'.I .t °~k,tAS ~
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C.:.. ~ ~ ~ ; ' COURT f
Nor 10 I o4 PM'T5~
3~~85
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of a total value oF. - dollars (s ~
j a~ ~ )
c~
of whist there remains unpaid s ~J U ~ X ~ ,for which amount he claims a lien on the fdlowing , -
- / /~a/1 ? S~ ~-uCl L
described real property in ~T~- 6 ~ ~ y~ U~! / County, Florida:
(Describe real property sufficiently for identification, including street and number if known)
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Owned by-_.. f -
s _ _ _
Ffs further says that lienor furnished the first of said labor, services or materials on ~ `
~ ~ l-~ 7~~
s 19.--....., and the last of the same on . 19 7.'~', and (if the lien
i
is daimsd by one not in privity with the owner) that the lienor served his notice to owner on
~..a~~ 19 ~~by ~ S~~ ~
(Method of Service
Lienor~~ L
By _ _ _
Agent or Attorney
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Sworn to and subscribed before ms this........f
~ ....................day of ~ - 19 ~ S
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V ~ -
~ 4.. Notsry Public
,
"!%u lii~/r!/n!r/// ~?r~ j~drriJ-~~,. ~ _ NOTARY PI;ELt~ ~7STE of FLORIDA st IARrf
i ~ ` : ~ ~ • MY COMMIS~I(,~ t:..-'.'.ES JAN. 1Nr 197
.•I~It>rrxl - BONDED THRU GE:tErAl INSURANCE UN11Eni+~~ ERS
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