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ru? »n w~ECwuuca• RAMCO FORM 120yS
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H D Staines
Before ms. the undersigned authority. personally appeared ~
who, being duty sworn, says that he is thelisnorhereinwthsagentofthslienorherein...••••••-•••••--•
Ilienor's Nams) j
's-
whose address is.....1~l1i5....~.~r....~$~Q>l`la4. ~t1i~°~,...~...3~?~~?
(t.ienor's Address)
and that in pursuance ofacontractwith ..............T1~lx:t~!!-.R00~..~•90~~~~i4Os•.~.lc~•..•-•-•-••----
lienor fumished labor, services a materials fconsiating of: (Describe specialty fabricated materials separately)
Labor and ~[atsrial !or tooling.
on the folbwing described real property in St...Lin~10 County, Florida:
(Describe real property sufficiently for identification, including street and number, if known)
10500 A]A Jensen Beach, Fla,
Turtle Ree! Condo I
?hat part o! goverrneat Lot #5, Sec. X11, Township 37 Range 41• Govsrnetent
Lot tl~l, Sec. 1Z, ?ownahip 37 Range 41• ~ ~ ~ 250 pg. 2852 Hld. C. That
s . ro ~L7 7 1:1'1
part; go~erndsnt Lot 1, Sec. 1T, Township 3l, ~d ~ a~ j„ re;•
Bld. D.
owned by--...T.urtle..Reel..Asaac...Inc. •
of stotal value of ....Tt(elltj.,se>~.TtlQUis .........................................dollan:lS ......~7s~-+~---•
I' of which there remains unpaid: •.---•~7s•~~•~~-••-•-••••-•- for which amount he claims a lien on the above
described real property.
Sept. 14
E He further says that lienor furnished the first of said Tabor, services or materials on
........................................19....x., and the last of the same on.....DIID.....~~.--•-•--.............19:..x., and lif the lien
i
j is claimed by one not in privity with the owner) that the lienor served his notice to owner on ~O~Re
..................5...............----.19....7.9.... by....Hand..carried-•to. Hagen. Hraia,.- Prefiident......-.------•-.----.-..
(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
(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
(Subcontractor)
~ {
'ry
on .................:.....~g~Q-J~1.-.2....~...~.4cJ..........19...........b~.............-~---......-----...---..............---~-••-•----•--......-....
(Method of Service)
f fl~f'fCl>K~tU
11CIE CptItITY.FLA.
pA6,t;R POITRAS .......T2'1..CAVn~..RAOSiAg
tt~~T C T V or
~COgk>lEMtt- iEQ...._ ~
fsy ..t. - .
4 ~ - Agent
lt. tiijl Ufii{.
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Swom to and subscribed before me this_~.::i~_ of ~
: ......................19.Q.....:.
' ~~Z~:~
~ - IQota Public
- Notzry P~ State of Florida at Largt
This /nstrumpnt prepared by: ~ c~
~ _ My Wa~:xsirr E,rpres Nor. 8. 1982 i
Address . ~t bw_~~ lIr Aw.,.cr. fa. L C.w~• r
' ~ ~ • BOOR ~~Gf ~l