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rut ran trcteurrxs~ RAMCO FORM 12015
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~I~tti~it ~t~rt
~att~ of 3t . Lucie ~ i
Gar M. DePalo~ 3r. f
Before me. the undersigned authority, personally appeared
_ ~
who. being duly sworn, says that he is the lienor herein or the agent of the lienor herein, ...~83on~lwjp
Fasteners--and._-Bquiplnent••Co. !-Inc..-, d/b/a--Coastline••Fasteners-and - -
Equipment Co. ! Inc • (Lienor'a Name)
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-whose address is...........'J~7.O---4`~!1...!+:2...5~~@8~
..........................?!'I~.X41.1-...~''.~..~r~.d8............................,
(Lienor's Address) _
and that in pursuance of a contract with F~---Industries _
lienor furnished labor. services or materials consisting of: (Describe specially fabricated materials separately)
e=tension cords! air compressors screw guns, miscellaneous items ~
on the following described real property in St • LLiC•3@.-,-.---...-.....-.-.:.County, Florida:_
iDescribe real property sufficiently for idenSification, including street and number, if known)
OC$ANA-( Hutchinson Island)
9700 AIA Jensen Beach! Florida
A parcel of land -lying _ in Section 2 ~ F
Township 3? South, Range 41 East; -
St. Lucie County! Florida. _ _ ~
owned by......Radt~.o~,'.-0~ea~na..~'axt~.enc.shy.D
One thousand t~to hundred twenty-
of atotal value of ..f ~V @• • .321(1 ..12~OOO. • ZXRXJC7CZX7L3CXX7~7C7C7CX]C~oUars (S . -11-.~'-..2~ • 1.2 - - • • -
of which there remains unpaid 5...1-! 22~r..!.i2 fo? which amount he claims s lien on the above
described real property. _
He further says that lienor furnished the first of said labor, services or materials on
Jj~1.Y....9 , 7~9...., and the last of the same on.........-... Jul-Y...11....-.. ,1~9....., and (if the lien
is claimed by one not in privity with the owner) that the lienor served his notice to owner on
..............July...31........., X9.7.9.. , bY.------... c~rt~fed..mail................-- - - -
(Method of Service)
and, (if the lien is claimed by one not in privity with the contractor) that the lienor served a copy ~f his notice to
owner on - -
(Contractor) - -
on -•19-........., by...........~....-•-•-----•-••-•---.....-----...------ .
(Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
of his notice to owner on
4~~?02'T7 (Subcontractor)
I I
r . ~ (Method of Service)
s~ 9 25 P~ ~ 12 MASOrTKWIP FASTENERS & EQIIIPMENT - CO, c .
d/b/a COA,3TLINE-. F~S..~EI~]ER$.. &..k4QAlPl~NT...CO. , Inc
FIEEO AN-'-=Gvd~: U
ST.LUClE C4±%IIiY.Fi A. Lie or -
ROGER PQITRhS `,Q
ClER:S CIRCt;t7 CC' T _ i- •rY'`' . y
B .~ieµ, lwt..
Agent- :
~,S'!b~'.- ~s~ gt~~b~:~s.;~
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Sworn to and subscribed before me this........._.......... 24 ..da o September'': ~ Q' - ~ ~ d ~
- - ~`g Qo; t- 3o- =
Notary Pubt'ua~ C_`
7Yt/is /nslrunt/'rtl prrpar/•d b~-: E118 Boutwell ~~""4 ~'~t~' ~ ~ ~JATE CF~(LORIJR+Aj, j~QA~4
~I//~r1'~.t ~~+t_,~ /tY EV`d:%~f~SfGii EXPli2E:a MARCH 1g~~~~d
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