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494148
r?A MECwuucs• RAMCO FORM 1205
ucM u?w. rs qua
~~t11T ~t~Yt
Before me. the undersigned authority. personally appeared ~
who, being duly sworn. says that hs is the iienor herein or the agent of the lieno? herein,
(Uenor's Namc)
• 751-I Pinetx+ee Drive Indian HarbC?ur Beac3~, Fl. 32937
' whose address is ,
- ILierwr's Address)
and that in pursuance of a contract with.......~~. OD~13tri]R''tiQl
iienor furnished labor, services or materials consisting oi: (Describe specially fabricated materials separately)
1NSTAI.T~TICN OF BUIi~ER 836M F~~PLA~ AND 325 9Qt1A~ FEET S1C[~
on the following described real property in.-.~-'...I--~ .............................................................County, Florida:
(Dascriba real property sufficiently for identification, including street and number, if known) -
Int 9, Raintree Forest
owned b ~
Y---- -
of a total value ofR~-~Y>ICIU~Sdi1S~.S~Yr~I>=ZY~QIt~.-~la.X~y.-.i1~T1e.-6c-~r./doi~rs (s -1739.25---------------------•)
of which there remains unpaid 5.1739.•25••••••••-,-•--••,•,•-•••-•-••-•••••, for which amount he claims a lien on the above
I -
described real property.
I
~ He further says that iienor furnished the first of said labor, services or materials on
April 23 80 Jute 6, 0
f ~...19.------...,and the last of the same on..........-.............................1S'"........, anti lif the lien
~ is claimed by one not in privity with the owner) that the iienor served his notice to owner on
l
- -----`7u~e--9-s ..............19..E---• by----------------••-•--U.S. MAIL ,
(Method of Service)
I and, (if the lien is claimed b one not in rivi with the contractor) that the iienor served a co
y p ty py of his notice to
owner on
(Contractor)
on----------------------•---•--............................................ 79.........., by...............----•-•----................................................. ,
(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
_ _ s (Subcontractor)
3
i
s on •-p,~,--.. . . 79.........., by-----------•...................... .
• i ~ 74• -
~ ~~~u j (Method of Service)
t
• ~fiti['skC~COROfd
ST.tUC1E 000ltTy.f tA. DISTRIBjJPORS, INC.
ROGER f
CITRAS • • 'Y
CLERK CISC}liT C0:1 i Lienor
~ _
sr..... 3.!:-:::~-~:. •~:.....-..1: ~
' aaH 'Agent
~sa~~~r~r?ti~ ~ .
Sworn to and subscribed before ms this-_..-..~~.~. ~ ~ " ..................19.
, aQ~~ - • . • - -
w~.,..- -
P1Gf ~ ~ : x ~ Y ~
This /nsfrum~nl prepared by: Katherine M~~~~.~0°• •~~j` °
Addrr~ss751-I Pine ~ , r cZ'. ~tuy Pu56t. St+tt! of Haids st lxge
i tree Drive :.S"~;h:'~r~;;: - p~~.`~- My tomnrissioa Expiry Apra 2. 1983
3 IIldl~7 Har}btlr Bea(~1, Fl. 32937 - b.e.e b An~nnu¦ ie. a c.war. C..w.r
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