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rEw 197) MECHANICS RAMCO FORM 120`,
UEN IAW. rS 71SM
~w[tt Of ~lot~s t
~outdp of St. Lucia )j
Before me, the undersigned authority, personally appeared ppri 1 9, 1980,
who, being duly sworn, says that he is the lienor herein or the agent of the lienor herein. .
Bveratt...Il._.Chaabara..._.... .
(lienor's Hamel
whose address is ..131? Parkland .Blvd.... Ft. _ .Pierce.,...Florida.. 334S.Q
(lienor's Address)
and that in pursuance of a contract with Nr..- Richard..T...or..Dtrs.....Lindi ..~3. _Bahi.. ,
140?..Ponce..Ds.-Iwon..Prado-,.....Ft.. Pierca,..Florida.. .33450. .
lienor furnished labor, services or materials consisting of: (Describe specially fabricated materials separately)
Service Drafting Design re><tderd .for single fswily residence to be
constructed on Lot 4, Silver Usk Sstetea, Ft. Pierce, Florida, St. Lucie
County.
on the following described real property in St I+11C~~ - _ - _ _ - - _ _ - - _ . - _ _ . _ _ , _ _ County, Florida:
(Describe real property sufficiently for identification, including street and number, if known)
-Lot 4 Silver Oek 1;ststea ~p~ _9 ~ r ~ 2
4 X2434 FtLEB AhB tfCQltp:"d
ST.LI{CIE CBUMTY.FIA.
RQ6ER f~ AS
ffLERlI CIRCI~T ftpMltT
Rff'f?tP YCfflFtrO
owned by_.btr•..Richsrd..T, _or .Mra....Lindi. 0.. Buhl
of a total value of tdincteen- • Hutadre d NiAety Four -and 50/100ouars IS 1994.50 )
-
~ of which there remains unpaid S .744.50 .for which amount he claims a lien on the above
i
described real property.
I
~ He further says that lienor furnished the first of said labor, services or materials on . icy.. .
12 19 '7Q. ,and the last of the same on Jequery 14 . ~ g 80 ,and (if the lien
N/A
is claimed by one not in privity with the owner) that the lienor served his notice to owner on
, 19 _ _ ,
. _
iMethod of Service)
and, (if the lien is claimed by one not in privity with the contractor) that the lienor served a copy of his notice to
owner on N/A- - _ _ _ _ _ _ _ . _ .
(Contractor)
on _ ..19 .._,by _ _ _ ,
(Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
of his notice to owner on r}~p
(Subcontractor)
J. ' ( et d of Service)
'y ~
- Lienor
' By _ _
. , ~ Agent
1
y~
Sworn to and subscribed before me this _ ~,,,1, t~-' _ day of - - 19
rr
Notar/ PE'w~: bA'1.
l~hi. Irr..~rumf•nl prf•pnrrrl 1?~-: fAy Com:aission Exp:es FcS. 23, 1982
k~d.d ~y /ueerc.~ fir. l CssYr41 Con~a~f
rldrr....