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49192
M stn MECw?N~cs' RAMCO FORM 120ti'+
urN tww. rs rua
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of ST - ~icc-c.~
Beiore me, the undersigned authority. personally appeared
who, being duly sworn. says that he is the lienor herein w the agent of the lienor herein.. • _ •
(Lienor's Name)
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_whoseaddressis... y.~:I.l....... f~..... ..~~~.......1...----~~./..1.:'t.2.ti.~'---..~~!a.'-.........
' (Lisnor's Address) '
and that in pursuance of a contract with f.,.!~-.f'f.1. ti.~ .......+~.Y.~!K. T~.4'. R.
r..~1.:./?~ .....C. ,D~ /Nl. j'h o-12 N• F
..r.~..t.d..c~ ~.y---.irt..v.b.r.~.c..... ~°~.R..i~ .
lienor furnished labor, services or materials consisting of: (Describe specially fabricated materials separately) .
a~A- c r ~ r.`T- 21G~ To zT F~.c.c.r,~~:..~E- o..,~c i,v•- t!~/~ c
PP ~ ~ ~BO'JU`~ 18 P~ ~ 24 J 1.
7k6~~, ~ ~xu2~1 0~ ~T~~, 49Ui92
FIIEC A!~L' PECOLii)10
'7~^ . o n ~ It- 6 c Q ST. Lt?CIE COUN1 Y. Fl h.
ROGER POt?RAS
CLERK CIRCUIT COURtf
on the following described real property in h..t~ ~ ~ ~ County, Florida:
(Describe real property sufficiently for identification, including streetpand number, if known)
f~c*r.aS~ ~~.Ar~r/L ~t2Vt'~t.~~j? h')C~.~t. /HiQ,k f•-•t• l #y
owned by.---..A..Rt.~.ti.. .......Q. ~N...!~.~-~-~..IV.-<'•-•-•---• F
of a total value of ...._...1...~V.~-v..t.......... ~~-t.4.:r.~.~~~~ .................dollars (S -..~vd.: v.~.................)
of which there remains unpaid 5-.-..--~ r ~ ' for which amount he claims a lien on the above
described real property.
j He further says that lienor furnished the first of said labor, services or materials on ....~.~l...... . 7
1 ~
_ .196 v.., and the last of the same on.~~;.~!............ ,19.....d, and (if the lien
I ~
is claimed by one not in privity with the owner) that the lienor served his notice to owner on
V (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
owner on
(Contractor)
on....... - .......................................................,19...........by...........----•-----..............................---------•-----.........,
(Method of Service) s
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lien . e
Q urrr~~Py
.
• ~ ~
of his notice to owner on
,;+.f .
(Subcontractor) ~ _
.
_•s~..s _
'
5.. a-- - -
•
(Method ~ ~ - ;
_ ~ .J
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HOfnlpr fUKrC STATE OF iWt?IJJ1 /1T WtGc Lienor .
C eN~
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.l, ~,~SS,«~ 14JVtRE1 t>, tf?.s (m ~ ~ M
f3y
f~ONOfD TMR{) GEI~AL I!!f . tR~CH1MNT~
Agent
' Sworn to and subscribed before me this ....................~.................._.day of s~`.'"`•~-...................... 19..~...
- - . <<..~~ "YY~I<..
~ ~ Notary Public
')'his Irtslrunrr•nl prrq?nrrvl hr: J
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