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~ ,tor
a~c~r raowo~s
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se/ere rota. the wtdMeiBned sudrorit~?. P
who. bein8 du111 sworn. sitlrs that hs a tM Nenor hersirt or file aoerlt o1 the uertor IM<Nn....
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I~irnor's Manse)
whweis ........:.........2241~..8*...~..~~l~,.~~NIt,...~~..~mr~.d~?.33:4R~1.........................;
(lierwr's 1lddressl -
and that in purswrlce of a contract with .:.......rr~~
berlor hurlislted labor. services or met~rials oomisdrtp of: lDeaorib~ sp~ciaih hbricsted materiab sepxatNyi
SIIIQ.~i ~H~t~: YtlIDOYS SILL Q.?~ -
SLIDIAI. tL~83 D008 ~D ~F'OLLO 81~~
11878.81
St. baa3o
` on the foNo>"rirtp destxibed real property in ...County, Florida:
Ib~sctibe real propwty wNki•nt11? for identNication, includi~p sloes and rMtmbsr, if known) .
Lot 4 8~1oot 26 Hi..rr Park unit 3
Port St. Laois, Flaa~ida =
owned tw
5~1~~..C~?.31nad..~.F.....YQ
. t.sit~llatora..tmd.. ctmts,...~8'~8.81......)
of a total valve of R~gb?#. 11d..1~a?AOI~ . aiabA~?at~s.
` of whkh than nmakts unpaid: ......:.........•8'8.87......................• for which amount M claims a lion on the above
destxibed reN property.
Ha further sags that Ikinor iurnisllad ttte first of said labor, serviws or materiab on .....1-$-~
.18.........., and life Isst of the same on...... ~,n8n8Q................... ,18.........., and iif the flan
is claimed b1l one not in privity with tM owner) that the lierwr served hb notip to owner on
O~rtiliad )[ail .
2-1~ te.........., by........................
lMetltod of 8erviwi
and, l8 the lion k claimed by orte not in priviq with tM toontractor) that Use lierlor served a copy of his notice to
owner on ....................1ti?t~..L'mo#s'nation..aod..8od+alph.F.... Ya1~io................................................
. 2- ICoretractwl Certit'iod Mail
on .........1~~ ....................................................18.........., by........................................................................... ,
IMedtod of-Servic~l
and additiortaUy, IN life lien b da~rn~d'tN one not in privity with t11e subcontractor) that 1M lienor served a Dopy
of his notice to owner on
l8ubtoontractor)
on ...........................4'X6160.....................,8...........~?...................................---....................................
INleatod of 8.rvice)
~p FEB 14 ~ ~ ~ 5 ntic!!n............ pm~acrs
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CIRC.Wf ~ dy ~ • ; , `ant
8womtoandsubscribedbatonnNthb. nth -day of;:,~,y _ :.~v•••••••-•••••••••-•••18••••x-
` This Instrument re red Co~:ioa ~ ~ ~ ,
t P Pa a,.a+ a rw a two . C 4,'~ ~
Address _ _ _ = ,;r. •'...~,,r:;'.;~.~ = y