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FLA. 1967 lAWB ~~0~ ~j~ IIAMCO fOnM 110M
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~tte of ~losiDx ~ #
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Before me, the undsrsi9ned authority, personally appeared . E~tin. P,. F.uah
the agent tt 1
who, being duly sworn, says that he is the lienw herein or ;the attorney S of the lienor herein, '
....~!~.n..f3.....f~.v+sh,...Preaidenx...flt:.~DSH...PDOLS ~ PR?CA.ST,...?*I~.. _ s
(lienor•s Name) i
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whose address is ......33Q4..Qle~tm~er.,...Fort Pierce, Fl 33450! . _ ~
(lienor s /lddress)
and that in pursuance of a ooMrsd with k .Mr~....YiACe...,Autonucci I
..,43b...Skipper...Lane~ ..Port. St.. Iucie, Fl 33452._ .
lienor famished labor, services or materials oonsistirl9 of: (Describe specially fabricated materials separately)
Mpteriala necessary to construct sviaming pool aria epa
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.dollars (S 12 ~
of a total value of.....- -~12s904.44 s~••~+1+ )
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of which there remains unpaid = .12,90/;.!,4_ _ for which amount he claims a lien on the folbwing
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dssaibsd real property in....--.-._......_.....St.....Lucie County, Florida:
(Describe real property wfficierltly for identification, including street and number if known) s
436 Skipper Lane Port St. Iucie, Fl 33452 ~ ~ - ~ . . (
Lot 6 Flock 25K Pection 24
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Owned by.........>~.... Vince . Antonucci. _ _ . _
F1s further says that lienor Fum'ahed the first of said labor, services or materials on 12.•13..?B ~
19- and the lad of the same on ................1~.1D-?9............. 19 _ ,and (if the lion ' ~ ~ ~
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is olainled by one rwt in privity with the owner) that the lienor served his notice to owner on Januaryr
r 19-~?g, by.. _ Certified .Fetter. _
~ .........ihr-ee
' (Method of Service)
gush -Pools . & .PrQCastr Inc. -
e Li.nor i
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A~eM or Attorney
e Sworn to and subscribed before me this..........~.~ _...............day of ~U./1.~.. 19
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Notate ~lic ~ L• , .
Thu launimrul fin fkrn~l l.y: ~ ~ • ~ = .4
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