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rtw un irttw?r~t~' ' RAMCO fORM 120sM
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Betors m~. the und~ni~ned authorit~r. p~rsona~l~ app~a~sd ....ShAi.I9..5,.. Q.4C1~t . _
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who, beiny dul~r swo~n, says that M is tM li~nor herei~ w the a~ent ol ths litnw harsin.
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~ Truli~e Industries, Inc. 1200 Pope lane, Lake Worth, Florida 33460 "
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I~i~~'s Name1 `
whoss addrsss is . . . . . .l 20Q . PO~e . Lane f ..Lpke. V1lt~~.. FI.QritdA. 33!~O . . . . . . . . . . . . . . . . . . . . . . . ~
~ (U~nor's Addressl ~
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and that in pursuance of a contract with.:.... BC1~ry InN111 . . . 1
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.......................7.~Q8.~e1.Air.~.Axen~Rs--~.gk~.~tood.Park~. Ft_,_.Pierce:..Fla,..............
lienor fumished labor, ssrvices w materials consistinq of: IDesc~ibs spscially tabricatad materials sowrately)
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Trusses
on the following described resl propert~? in St _ Lucie County cou~~y, Florida:
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(Describe real propert~r suHicie~tly for identification, i~cluding street and number, if known?
5704 Kings Highway, Lakeaood Subdivision, St. Lucie County
Ft. Pierce, Florida
owned by~ Mr. and Mrs. W. E. Blakeslee
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ot e cotai ~si~e of ...On~..~housonsi .Eight..Huc~dc~d.Forty..~i.ghf.au~d.48/AQa~s ~XX?~,~4XX.. ~
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of which there remains unpaid 5..........~ for which amount he claims a lien on the above ~
described real property.
` November 17 78 ~
€ He further says that lienor furnished the first oi said labor, services or materials on ,
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t . 19.........., and the last of ths same on....... Noyember_ 17~78. . 19 and (if the lien ~
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~ is claimed by o~e not in privity with tM ownsr) that the lienor servsd his notice to owner on ................3~~S~Q... i
€ t9..........b~....-~- ~ .Certi~ed__Mail. - - • ~
; • ' (Method of Servicel
~ and. (if the lien is claimed by o~e not in privity with the contractor) that the lienor served a copy oi his notice to
Barry Irwin ~
a owner on ~ ~
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~ (Contractor)
3/28%79 • •
on , 79........... by~~.~If1~..MQ1~...... . :
e {Method of Service)
~ and additionally, (it the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy ~
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~ oihisnoticetoow~eron - . . '
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~ (Subcontractor)
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¢ ~~1..SSa; .Tn~Line.lndushies,_ Inc. ~
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~7Q ' ~ ~ 3 ~ y6 Lien +
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~ • ' Sheila S. Bone . ~ ~js' '
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~ Swom to a~d subscribed beforo me this..........--_--....... ~h........_......da~ of .,....A~N'~#.~ ;~............19. 79 ;
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~ 7'his lnslrum~~nl prc~por~~d b~: , ~-='.-Q
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= ~1 d.l rrs.s S. S. Bone, 1200 ~ Pope Lame Lake Worth, F l o. 33~On • r~E~~,:` `
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