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HomeMy WebLinkAbout1061 e . sr i ru? +rECw?r+cs• RAMCO FORM 120K uEr uw. re »aa ` ~l~im ~t~n . ~ 484~~ ~ St. T~tci© Before me, tM undersigned authority. personally appeared........ ~`an!c• CoFTan•.,.„___•...•,•.... who. being duly sworn, says thayyt~~h~~epp is the lisnor herein oar thVe agent of the lisnor herein.......... Slt'1L)O ~TILDIIW 5~1~-~-~ .c 1 1Uenor's Name) whose address is..........20~ firenuo C,•••• Ft. Pierce; Fla.•.•••33l~50 ' (Uenor's Address) and that in pursuance of a contract with......., C 1TA C02ISTRUCTION CORP. 8380 S. U. S. #l, Pbrt St. Lucie, Fla. 331152 lisnor furnished labor. services or materials consisting of: {Describe specially fabricated materials separately) 309 1/3 ards (12 232) Vildn~ Scri.~a~e Carpet--Copper Glow--Foam Sack Installed in all areas of S~.~ites 9 and 10--F~cept BatnroorTs on the following described real property in . Saint Lucie ..---•••••••.--County. Florida: (Describe real property sufficiently for identification. including street and number, if known) X380 Soot}i LT. S. :;'l, suites ~ p- 10 Port St. Lucie, Florida 33t~r2 C 1?'A COi:ST'?~CTIO:' tiID LUIS C.3T_1 :L:? LOUIS ~'OA owned by of a total value of j FTo t~~ousard,threa hundred,tt~3.rt;T two c. 35 (5 2,332.35 of which there remains unpaid S ~ ~ 332' 3 ~ for which amount he claims a lien on the above described real property. He further says that lisnor furnished the first of said labor, services or materials on Dece7_'ZJer 31 ?c` JeceTnUer 1 r . 19.....:..... and the last of the same on.........-.............. , 197...., and (if the lien . ri]. rs claimed by one not in p?ivrty with the owner) that the iienor served his notice to owner on ~ t9~'.Q....., by--, ae,ist~red •'`~-?.~-s.. ?et~n. Pequested-........................ (Method of Service) and, (if the lien is claimed by one not in privity with the contractor) that the lisnor served a copy of his notice to owner on C.1T1 CO:iSI':~?TCTIO:T ~,;m LTJIS Ci?'.1 .1:D IAC'IS ::OA ~ontractor~ 'nril 29 19....`}~., by-.-.-- ~~e;5stered•- 2;311.•,•• P,eturn Req~:-sted - on (Method of Service) and additionally, {if the lien is claimed by one not in privity with the subcontractor) that the iienor served a copy of his notice to owner on (Subcontractor) on 19---......., by.....-............... (Method of Service) 29 Px 24 sr~o :fi~nr-; f S'TPPZ° ~ t{~cC F~ 6aA~t 0 or rt~o QolTfza f • . ~cfacclscvltcsusu'~' ~ , u;.., By. . ! y t ~ ~ Agent Sworn to and subscribed befo~•m~.dlfs_'_rp. ~ =r~-~- - --d f .......1 . _ aye r'~~ 9.8U j _ _ . s~ , ~ t ~ ~ ` f; Notary Public J'Iris Insfrruur~?r? prr•purrd hv. - /~/~f1!~.~ it c-. ,c ~T '^1 4T "E ^ J I ,..5 s m_ -