HomeMy WebLinkAbout0208 .
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t~l~xtm
State of Florida
County of
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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 ~
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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
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AT.. a~K3~5 ~0? ~ Commis~n Expires:
,.,sea,