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FIA. ,e67 ,.AWi ~ I,AMCO FORM ,lOM
Ff a.oe x'76918
~i~tim t~~
Before ms, the undersigned authority, personally appeared......-.Keaaletth...L,r....Stone............_........._........ _ .
who, being duly sworn, says that he is tM lienor herein or the agent of the lienor herein, .
the attorney
Kenr?eth L. • Stone d~b/a Ken Stone ~ ion Pluabing _
- (litnor s Name)
whose addreu is----•-•.1119...111,~t~d~1...Avenuer...Fb?~`t .Pierce,..Fl...........33!~50.......... _ _
(tierwr s Address) -
and that in purwanos of a contrail with ......I+t~$ . Cats?.. dl~~s...Cata Oonstruotion . _ ,
lienor famished labor, services or materials consisting of: (Describe specially fabricated materials separately)
Pluabit4r pipingr fittings..fauceta. fixtures and labor to install aaae.
1~to thousa#~-------------------------- ddlars Z 2000.00
of a total value of
of which theta remains unpaid s 2000..00--- - ,for which amount he daims a lien on the Following
described real propsry in. _ . _ St.....Lucie.__.... . County, Florida:
(Describe real property sufficiently for identification, including street and number if known) y
i
104 Lotiaa Oourt. Aivar Park
190 Eci 22 ~ 2.54
Fi~l.i1 tvC F: ~ua::E
SLLl+C1E CGv~iY.t~~
ROGER POITR!'.S
CLERK CiRClfli COU~
~'76918
Owned by.--..Luia•-Cats..d/b/a...Cata...0onatruct~.o~a. _ .
Fle further says that lienor Furnished the first of said labor, services or materials on. - - - -
...........t?ctA.be~c..l.Q..--..--. 19.x••, and the last of the same on •--.Janl-.. 19~_ ,and (iF the lien
I is chimed by one trot in privity with the owner) that the lienor served his notice to owner on
.........,19.........,by-_. - _ _ _
(Met of Service)
Lienor
By_......- ~
Agent or Attorney . ' a - - t
Sworn to and subscribed before ms ths day of
r- -
Notary Publk, StsN ~ Florida d Lar~pe - _ ; - ~ - t
M comrti - xpires febrwry 4, 1481 ~ J!!~.~CC
_ L .F ; -
°M bonded with Lawtrers Suretp Corp. Notary Pu~it• • ~ ~ ~ -
%is Lrs~ninrrrd lrr~ fain /
y: . _ - ~ 4
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