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459654
r~A. ~M rrECw~~C~' „ RAMCO FORM 120Ne
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8efore ma, the undersigned authority. personalh appeared . - .
who. bNng duly sworn. says that M b the lienor herein a tM agent of the lienor herein...
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iLierror's Namel
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whose address b.....~7..~8.~~c.?..~..'.Kh~1..4.'....~~~..s~~..Q.l~(.i..?...4..1~~.~! Iq ...~.17..~.y,~.c2~ .
(Liereor's Address)
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and that in purswnq of a contract with...:...~.~.1:.~... C.C~ M.N!lP..l'L.I.C ~ ~:.~.,t^Qt~1~S7,.I!'.Ql.~ P.~........... ,
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lierar famished Tabor. services Or materiab consisting of:lD~cribe specialhl fabricated materials separately) _
TivTPez~on, Co M~plpfe ~ p6locrcc cT o c~u ITs
on the folbwing described real property in .......~.1
' ~ ~ C.)..E-~ courny. Florida:
)Describe feat property wfficiently for identifigtion. inchrding street and number. if known) .
/ 9• ~9 ,gc~zes e xr S7'r~7e 'i?o p~ T~1 a Fore? ~i~RCe , FAA
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S/S/ S7pte slc~ FonT~iPa~e ST, ~l,ucit ro4uTr
- 8S7'o~~ ~oN:d, N,u,_u,~~e~~a t yo tiv,rs pin bId .
owned by..C.~~y:P~tT g,A~!!.?.t..l7t?.tt.~Sd.~I~..FS .u.!.C!<~..2~!~A.!u~L~!~T~.g.~. ,~ylrS?MltrT.. Ca.~.p,~......
''SCI ~ ao,~9 ~vw aavti.>p n.,rcN,Noa~d~
of a total value of /.111.C.`sv,K.~tZ~c.~.~SI~cT.~.,TnauS~?.N.Q doNars .S~Q,~O.Q~Q..l.9flEzx..1
of which there remains unpaid i..~~ ~ for vuleich amount M claims a lien on the show
described real property.
He further says that lienor fumist~ed the first of said labor. serviws a materiab on
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.....................1e-.7..~., and the fast of the same on...~.P.~"r..l`~.~................19..7.9....:red lit the lien
j b claimed by one not in privity with tM owner) that the lierar served his notice to owner on
, . bt?--...-----...------
IMethod of 8ervicel
end. (if the lien is claimed bt? one rat in privity with tM contractor) thst the lie+wi served a copy of his ratite to
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owner on ~?T..
lCawactor)
on .............5'.PAP:r'..1.9.~........-------.....................ts..7..~..by....-•---- .~9oN.'.~......................................-.........
- (Method of Service)
and additionally, (if the lien is cisimed by one not in privity with the aebcorraractorl that tM lienor served s copy
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se ~.T....~$..,...~ ~ G. ~ a
of his ratite to owner on
tsubcoretractori
on ts......... by........................................................................... .
X19 SEP 19 P!~ IZ= 14 IMettad of S.rvicl
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FtA. ~fOf
~ER POITAAS
CLERK CIRCUIT COvitT -
- Agent
Sworn to end subscribed before me this- ,da~oi''ys~ ...............18..71:.
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~ . = r Public
Ibis Irutrumpn! prepared by: '-F = - ~'r 11~ic. State of Aida st LYge
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