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ru »n rtcwui+cr RAMCO FORM 120
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8sfore me. the undereigned authority. personally appeared ~...I....
who. being duly sworn. says that hs k tM lienor herein or tM went of the lienor herein.
_ -
Desigzl CerpeL: and Floor Gcyvecing Oorporat3on .
- -llienor's Name) - -
ri 33450-
whose address is......~..~1$~~..~~,..~Q~..~~..~....a$
(Lienor's Address)
and that in pursuance of a contract with......~~ .~.~.~'~.Q.4'~....+.~~~4?~..
wife, . _
lienor fumishsd labor. services 3-?.-~ateriak, cora~sting of: (Describe spscielly fabricated materials separately)
- Installation of Carpet end pad - ,
on the folbwing described real property in . St • County. Florida: -
IDescribe~resl property suffidsndy for identification, including street and number, if known) ,
_ 651 S. E. Dwii>8, Pert St. huci,e, Florida 33452 -
Ivt 4, B1,oclc 229, Port St. Iucie Sect3An 28, as per
_ plat thereof recorded in Plat Book. 14, pa4ge 7, Public -
Reoords-of St. hirie Coanty, Florida.
owriad by._.~aStid.~lbrittQn•-azxl $11a~7on-A1btittO~II,..hi.8..~fe,------------------------------------------•------...
Qae thousand aae +ed thirty ~/100 -
of a total value of dollars (S ....~,.,.~~?..7~---
of which there remains unpaid:..:..... 1:1~ r.~ far wfiich amount he claims a lien on tM above
described real property. -
f He further says that lienor furnished the first of said Iabor, services or materials on ~ • - • • • • • •
_ - . ,19_.79.... and the lest of the same on.....~r~.D.1?.~ . ...----....19.79..... end (if the-lien
is claimed by one not in privity with the owner) that the lienor served his notice to owner on .
.....:..Uec~u?ber..~..:-------~. ~9---79-, by------------ certified-U.S.••mail-------------•------:.._.....------------.........-------
MMethod of Service)
and, (if the lien is claimed by one not in prhrity with the corv~actorl that the lienor served a copy of his notice to
-owner an
(Contractor)
_ (Method of Service)
and additionally, (ifi the lien is daimed by ores not in privity with the wbcontractor) that the lienor served a copy
of his notice to owrser on
a (~JUbCOntfaCtaf)
....g;'715.........t9:....:.....by....-.----- -
++•+urr~t, IM of ervice)
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RCW'[ COtln ~ Agent
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. ~ 19.
• : - day of Jam......---•- - -
• • - atabscribsd plalli Jff~
- My. Cvfaciission Expires : 12/20/80 - - - -
ublic .
This /n slrunrr?rf nrrparrd bti•: (~grle8 J, ,Esq.
;lddrrRS P.0. B~ 3~
- Fart Pierce, Florida 33~>50 ~f f