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HomeMy WebLinkAbout0208 . J i i • - _ - `1 _ - ~ 1 t~l~xtm State of Florida County of - Scf~- ~s T~ c _ Before ms, the wtdersigned authority, Peraortaw appe~~ - j 4 who. beirp duly sworn, eats that he is the lisnor harem a ~ the attorrtsy ~ of the lisnor herein. s ~ S s (lienor's Namel Q~ ~ ~a~wur~s KoczJ Pi ~!'ce t ~ f - whose address is lliertor's Addresst l Perk' ~.r,r`c ~ l4u. ~c~ers ~~~'*~-~-.~~~J and that in pursuance of a contract with _ I~'~„ ~fS ~ - A w.•. and fa the improvement of the cad property. hereinafter described, lienor ftrrrtished Building Mate ialS. dollars IS r+ ~ Dv 9 ~ t of a total value of of which there rarnains unpaid fi v • Oo ~ ~ - for wtwch amount he claims a lien on the forowing ,~+rn•2 g k 3S6 ~o+ I I p~}S~_I,NC; ~ ~ S~.~uci a Counb.laotida: descxbed real Property in ~ (pescribe real property sufficiently for identification. including legal descr?ption, street and numberrt known.) ~ 19T9 AU6 23 Ali 53 ST IUCAttO~ OYROFEO owned by ~OY'~" rJ ~ - L uC i ~ ~ i ~ Uef'S ~i.~a/` V,1t9t^n¢ty V~¢~-~- RECpRpYERiftEtl He further says that lienor furnished the tirst of materials on S ~ 19~and the last of the same on ~ _ ~ ~ 19~ana ~rt the Tien with the owned that the iienOr Served his notice to owner On lr is claimed by one not in txMtY 19_, by IM of Service) 'c e A oopr of this Claim of lien has been furnished to l~,w, the above-named owner land aN other entitled to receive the sarr~ by urtified mai irstum receipt regtrsstedl. Prepared BY Cert_ a Number ~t ~ t t day of _.19 Mrs Address ~lti~...: pF~y~~y ~~0 Y ~ _ before me this day f s t,~a6 f~ Notary Public J?. ~ AT.. a~K3~5 ~0? ~ Commis~n Expires: ,.,sea,