HomeMy WebLinkAbout0294 FLA. 1e67 LAWa ~ ~ 11AMC0 FORM flOr
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Before me, the undersi~tlsd authority, Personally- appeared.........K0A3iQ~.h..L....3tona .
who. being duly sworn, says that M is the lierlor herein or ~ the agent # of the lienor herein,
the attorney
__,......~Cgnr}.eth.,_~~,_,~tone_..-.,.-d,~b~a ....Kea. 3tons dr 3on Plusbing
(Lienor
s Name) -
whose address is.-.....1119...Alaaeda_.Avenue,,...FbrL Piezce,..F'1,.........,~~?!'.50...-...... .
(Lierwr s Address)
and that in pursuanos of a ooMrad with__....~uie.Cats.....d~bt'a.......Data...tbnst=ucto>i......
-
Nicholas Duluicci, oxnt3r (Ferne?ndo Mirabel)
tenor furnished labor, services or materials consisting of: (Describe speaally fabricated materials separately)
PluRbitig piping, fittings faucets. fixtures and labor. to install salsa.
of a total value of.....-Dns...tbnuaartd _ni~te..hundred .sixty-five.---..dollars (S 196..00 _ )
of which there remains unpaid s.196~,.~._ ,for which amount he claims a lien on the Folbwing
described real property in .............._...._...3t.•.. Lucie ..County, Florida:
(Describe real property sufficiently for identification, including street and number if known)
S34 S.E. Anchor Lane
.Q ~ . 22 PM 2~ 55
Lot ~ Blk. 257 1Yact 24
f~tl[~ Esl t'~U~:+t a
51.~1h".IE CNV3t7Y.f!
ROGER POtTRa5
CLARK CtnCs;tl' ~ T„~
4~s~zz
Owned by--.-..I,uis...Cata..._d/.b/a ....-...Cats Construction ..~1iclxtl~...Dtt1>x~.G.~i.
- - (Fernando Mirabel)
Fte further says that lienor furnished the first of said labor, services or materials on--
...........Auguat...6. 19.79-, and the last of the same on..:~~...~.r........................, 19-~, and (if the lien
is chimed by one red in privity with the owner) that the lienor served his notice to owner on - .
.................Jata.....7.................., 19.8Q.-. by..titailed atatesasnt...... _ _ . _ - _
- (AAgthod of Service)
~ /
lienor _ .
BY _ .
Agent or Attorney
Sworn to and subscribed before ms this .n.~ - . ~ , ~ -
_ ..............................day of . ':•••1g~,~
Notery Public, State o~ Florida at - ~ _ ` ' -
,
,
My commiliion expires Februsry 4, 1981 - - _
' .
e,, n ~c7
Bonded with Lawyers Sur _ ~....~~t?~.G.~-!~!~r.
ery Core. ................1.~... ~ . ~ -
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- Notary Publ+c. t - - -
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l7ru Gt.~rnau•rt~ /?rr f?nrr J lry: - • .
B~.,x326 p~~E 294