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G. S. Macllillaa
Before me, the tmderaigned authority, personally appeared
who, being duly sworn, says that he is (the lienor herein) (the a ent)
(attorney) of the lienor herein The Burke Coatuany )
whose address is 1050 t1N 159th Drive~Mia~i~ Florida 33169 ,
. and that in pursuance of a contract with H fl ~ s construction ~ ,
~I lienor furnished labor services or materials consisting of
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Sale sad Rental of Building Materials
Invoice S74S8 11-20-78 159.64 Rental
12384 11-21-78 291.37 Sale
~ 12519 12-13-78 119.03 Sale
i 62911 12-20-78 63.86 Rental
68120 1-20-79 348.38 Rental
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on the following described real property in St. Lucie County, Florida:
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See attached. two (2) sheets of legal description
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~j owned by Hutchinson Island Limited Partnership of a total value of
~ 982.28 982.28
~ of which there remains unpaid $ and furnished
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'~i the first of the same on tlovember 20 1978 ,and the last of the same on ~
i' December 13 , 19Z~_, and (if the lien is claimed by one not in privity with #
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the owner) that the lienor served his notice to owner on ne~~hp>c 2t , 19_ZB__, by
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Sworn to and subscribed before me this 6th day of !'eb>•+ui'~.' 19 79
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Notary Public M Commission ex ~ j
instrument prepared byt 9 ~s~~~~:s. F:•'~
G. S. MacMillan - ~ ~,{r c:.t..+
j~ The Burke Compaay, 1050 NIi 159th DT., Miami, Florida `'~~~~~'r j
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