HomeMy WebLinkAbout0722 *~T~cfj~3 ?
ru? ~sn rlECw?wics- RAMCO FORM 120'S
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Lucie
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Before ms, the undersigned authority, personally appearsd....R1Chard E. Ketcham
who, being duly sworn, says that hs is the lienor herein or the agent of the lienor herein........
R.E. Ketcham- Masonr Contractor f
Ilisnor's Nams)
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whose address is:...2.~8fi.._S.E-,•.•Ei.~be•e...S.t.,.,.__~?ort_.St,..•~uGi.e.,.-.Flor:~.c?.~
hienoi s Address)
and that in pursuance of a contract with.... J.?i~le $....Ci. e...We t 2 .
....~7~...:~.E.....~Au:tu...~ex~xace.....~.opt...St......~rucxe,...~~.a ,
lienor furnished labor, services or materials consisting of: (Describe specially fabricated materials separately)
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Masonry labor for block work I
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on the following described real property in ..............i 1{ •...~U.C; l£............................................... County, Florida:
(Describe real property sufficiently for identification, including street and number, if known)
Lot 17, Block 402, Section 3, Port St. Lucie, Fla.
also kr~owrs as 1199 S.E. C~iftoT Za.^e, Port St. Lucie, Fla.
owned by.s~?.lI2eS...~rln~fry----.z.l.~.Ct.. ?~1...N.....'j.8th..St....,...F.t....i?3Li(i.erdal.P..r-- ~'1a...---•--......
of a total value of Seve.~...Runs.red...Thirty....Five...0.0~11.C~Q...... dollars (s ..73.~..Oa ....................1 '
of which there remains unpaid S..••-?~ 5.r.00-----••-•••-•---••••-•-••-••.--. for which amount he claims a lien on the above
described real property. .
~I' He further says that lienor furnished the first of said labor, services or materials on
,19~~...., and the last of the same on.....2~... 3rCh------------- -19~..-,.,-., and (if the lien
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is claimed by one not in privity with the owner) that the lienor served his notice to owner on
(Method 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
~ J?~es C. ~r:etzel
owner on .
a ontractor)
I 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 •
(Subcontractor)
on ,19......---~• by----~--~--... .
(Method of Servicel~~~tiN~ii;Ho
4~~
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1980 N,~Y 13 P~ i2~ 12 Ketc'.:ar~.- ~~nso_^r_
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Lienor i t ~ ~ s ~ ~ •
F Ell ADD ~=COR::f D ~ ~ ~ ,
S~WCIE CCUNiY.fEA. ~ ~
ROG£R POITRAS By _
CLEP.K CIRCUI i COl,'Rt ~ ~ ~ ~
y~ Agent ~y ' ~4-
T! i
Sworn to and subscribed before me this / ~
r ~ Notary Public
Phis Irtslrum+~nl prrpnrr~d h_t-: -
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