HomeMy WebLinkAbout1605 _ , -
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. ~ .4'758.35 ~ ~ /
raw usr ~ 11AMC0 F011M /20M
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s.for. m.. M. undatsi~rad•uatority. p«sohNir.ppw~«+..:..~~~?:°`,!....1~~~:!!;?.n
wla^. bNrp duly:worn. says that M b tfre )!error he?eirt a tM spent d rite Nsrto? hsrNn,
lLi«wr's/~Narnel
whow address is.... ..~¢,//ty_„ ~wa c1... , tftt~:.../~~ct
T_ (~hnor's Address)
and Mat in purswttce d a contract with...... ~`.',.a~!t.t......t,~ a!
t ~
~K c ~i o!~.... C,,• o
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5301...S~t ••.~s f' ~~.1... ~T.'..:I.: tea c J..~.l.a-...........
lienor furnished labor, setvips a rnatsriaht coraistirq d: DDescribe speciaill? fabricated materisbti sepsrately?•
~ Pir Zs.+tr.is •t7.s~ed ~ ~S•'y9
~r~w• -
on dte folk~wirtp described reel property in ~-~c~ t •,.„..,,,.county, Florida:
(Describe real property s~uHiciently for identification. indudinp street and number. if known)
C~~ w~f stir,..:,
3/3~' ~~Sor,~.f~ N. S. ~
/"vrf r'ntt~ ~~w-~c~Q
owned by ~i~ L'. snr • ~'~t ~ua
of a tots! value of . ~!'cN ~scti %
~1 w{ T.~i...x...!S/•.l.......~ .....F ...x 3 y~ OO
MW„ r ?t •.~i~ r or~ . ~ dOliars 1:....,/
of which then remains unpaid i.. 3} 9S.-Sd
for which amount he claims a lien on the above
described real property.
//11 He further says Mat lienor fumisfred tfie first d said labor, services a materials on
..h[!!~!!f?f:.... ~l .19.7..., and the last d the same on.. ~°.!':~'."bt~..'xS.......... ,18..79.., and lif the lien
is claimed by ores rat in privity with the owner) that the lienor served his notice to owner on
~s..~~.... ~!r
p.. by ...............~..................rYla..~.............................................................. ,
(Method of Serviq)
and. (if the lion is claimed by one rat in privity with the contractor) that the lienor served a copy of his notice to
~i
ovmsron ~4~M~r....4.°'.`.~~«Mt ~.~y....~.t.Q~
!contractor) ~ -nom . /
(Method d Service)
and sdditionally, (if the lien is chimed by ores tat in privity with the subcontractor) that the lisnor served a Dopy
•
of his notice to owner on z
• '
(Subcontractor) ~~..~Nti~' ~'r~u
,tan ~
4'58.35 ` ':t. r - .
a..•+~• ry..i'..
FLB ~ 2 ~ ~ 5~ (Method of Service)? ~ ' ~
REGlU:9 tE~1. _ ..T C'LL~T g ?/I-f rs Sri S t~ ~v d
- Y a
a.
8wom to and subscribed before me Mis.....~_...._..~~~ • ~ .19.0...
of
4~Notary Public
This Insfrumr•aJ iirr~parr•rl b.•: .
Atld rr :RS NOTARY /tStlC AJ1~ Oi
fas~~~ ~ oawtlsslat+ ~ twit. r ~ . ti~