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r?~ is» wECw?N~cs ~ RAMCO FORM t205~
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t~l~ttln tin
Before me, the undersigned authority. personally appeared ~iON,AI..A...R. r....AQFN~!
who. being duly sworn, says that he is the lienor herein or the agent of the lienor herein,
Treasure...Coas.t.. SuP.P1Y.~....a~??~a..DOby...Supply .
IUsnor's Name)
whose address is. .....1971_-_Commerce Av.:, Vero Beach, Fla. 32960 -
.
(lienor s Address)
and that in pursuance of a contract with .....................G .-..F. Industries
lienor furnished labor, services or materials consisting of: (Describe specially fabricated materials separately)
Metal Pruducts and Materials
n ST - Gv
on the following described real property in County, Florida:
(Describe real property sufficiently for identification, including street and number, if known)
X9900 Ocean Boulevard, Jensen Beach, Fla.
Commencit'~ NW Corner of Sec. 2, Township 37 S, Range ~tl E
owned by... Radnar/Oceans Partnersh.i~
of a total value of .Eighteen Hundred Seven and 00/100 1807.00
of which there remains unpaid S
1807 .00 ,for which amount he claims a lien on the above
described real property.
! He further says that lienor furnished the first of said labor, services or materials on --August
E -
4 20
f _ , 19...79., and the last of the same on.......Afdg.LlS.t...~O. , 19.._7.9., and (if the lien
i
f is claimed by one not in privity with the owner) that the lienor served his notice to owner on
E Augus.t..2.8 _ , ~9..7.9...by.........Ce.1:'tfied-.Nail
(Method of Service)
and, (if the lien is claimed by one not in privity with the contractor) that the lienor served a copy of his notice to
owner on ...._....P.eX'~n~.@...~'rAX1~~'aC~.i??g.........._.........__.........
August 28 ~~Contractor) Certified Mail
(Method of Service)
and additionally, (ii the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
of his notice to owner on pp
~~~V~ (Subcontractor)
on _ r~~,,...f.~....,.~,.. ~9...... , by............ .
. 3=-37
(Method of Service)
F+.::o e.rs F+ a Treasure Coast Supply, d/b/a Doby
f RCG~f: f't'ITI';_S ...................................................._......._..._....S.upply
CLERK C]R:L" C' Lieng~ 1
• = ' ~
Agent Ra'r,; oehl
Sworn to and subscribed before me this 16th_ _ _ . .-.day of ...NOV@fl)~Je3~ ~ g 79
- .....rte:..
. filo~y Pub ic'-' %
t 1'Gi.Insfnunwtl pr~~pnr~~~l h~-: Ilvl Szirony
1d~lrr.~.c 1971 Commerce Ave. Hoary P;,~%~tete of<f~d;?dl~tU~~
Y e ro Beach , Fla . t~R 3~.t! PAGE ~5'~ Mr Commusign E,~irl~ aka; fit, -1:33 1 ~ g3
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