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HomeMy WebLinkAbout0229 . ~ s ~ - _ ~ I - - - w? :qs ~cww~a" IIAMCO f011~1! t20Yi - ?ms tww. ?i ssxe~ ~ t Before rr1e. the undersigned authority. ParsonallY a~~ •1L . - wfw. being duly sworn. says that he is tfse fiance herein or the agent of Henor harem... _ .....1.~la~~,l.~j~........................................................................---.---............ Ijlfenor's Namel - - whose address is... ~s~.c~../..... ~'.~'.1........ ~l.~..l.......~C.~ . I~ierlor's /lddress) - /J - gy~pp. and that in pursuance o! a contract with ~ / lienor furnis~heLd labor. lervices a materials corgisting of: IDescribs spsciaNy hbricated materi.~b separately) - ~.1.~.-..~.(~G.'~.~- ...........................................Count1l. fioric+a: on the following dss~xibed real property in IOeswtbe reel property suffkiemly for identification, irldudirlg street and number. 9 known) ~ - ~a-vc~i o f j~r~r ~y~~,f ~•r sce . a a, ~u~ir ~ ~ ~ 6 ~c~c /~'cragC ~,u ~'a 5~, a s cis eri fJPC/ ~t G~Ffi c~:u-/ .~fG'esd ~,C 3EG, j`~? 3d5L rLwv ~a ~ .~~c~e Coax-spy, ,.vz ' Lys.// .l~uttt'~` t'~ il'~ ~ ray of a total value ofQ~~.~~.~1i2[$...~V.e../ll~~l~-•...,5.~"~~.-'•~-ivCdollers (i . ~1.-..til_..-/ ~..l.~.A....) per f` ~,1 ~ _ of which there remains unpaid:..at!•~.:~•-~ t-~..R•! for which amount he Maims a lien on the above I~ described real property. _ ` Hs further says that lienor furnished the first of said labor, Cervices or materials on....._ , 79..~~.., and tM Iast of tfss sane on-------------••~~..~ ,19.7. and (if the lien is claimed by one not in privity with the owner) thst the lienor served his notice to owner on._.• E - - ..!%:P!:1!...--...~..--•.19.7/1... by..~Q?I.~~G'~C.'~~...:~.Y..I.fi.C.'~C:....~UI."~~G~,.~a~F/ - ~ (Method of Service) - and, (if the lien is claimed by one not in privity with the contrartorl that the lierwr served a copy of his notice to owner on (Cormactor) on .....................................•-••----...................19-----•----• by-•----...-----.................----...-----•----..............-----....... , - - (Method of Service) =and additionally, lif the lien is claimed by one not in privity with the subcontractor) thai the lienor served a copy _ of his notice to owner on (Subcontractor) 1 by: f'1i.El~ ±.i{Q F;C01~[?~u iMathod of Service) - 3T.UlC f:0~ TY,FLA. - ROG~R pOiTRAa - O,ERI(C1iFt;IflT COUPT ~ • - ....1-•-------- t Lienor . fk'C6itD 11ERif lf:i!_ - .n;.~~ - ~ r~ ili~tlli~ a - ~ • 4~131 agen~~'- ~ , : -l,•~j• - ~ . ! y~ A~. Sworn to acrd subscribed before me this..^_--~ _-day of G~~t~%j~fG. ~ J,~:)-t:- ••~~7~~•-.. 'J ~ G - )IotM? tits of R~~ t~ ' ~ s _ _ 7 ~ _ _ fhr Co~ssnassut: Expires 7. ~3 yl~.~.7.. .~t.~....... ~ . r- - _ ?:~:fie t• ~-«.r vn _...s) C.~:.sir ~ ~ ~ w ~ l./ NOS ~t.©1a c~': l 7%:rs Ltstrumr l nre~pareii Ly: ~rr~~~~ ~ d- ~ - • N~r•'~-~`~~ i ~idr/rt:ss B(3~Kt~(..~ PJ~E ~'_~'~~y~~,'!f~•1~w~''