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' fu H71 MtCwMKS' . RAMCO FORTY{ 12014 urN uw. rs naos ~l~i~n ~i~xt ~ ~ St . Lucie • Before ms, tM undersigned authority, personally appeared ORVAL L . SHELTON who. Ming duly sworn. says that M h the lienw herein a tM pent of the lienor herein.. SHELTON CONSTRUCTION IUenor's Name1 - • whose address is.-P 0 . Box 1992 , Vero Beach, Florida 32960 (lienor's Address) JORGE F. MURGIO and that in pursuance of a contract with . lienor furnished labor, services or materials consisting of: (DescriM specially fabricated materials separatelyl Construction of restaurant and other additions to existing motel. St. Lucie County • • •...ca,n . on the following described real property in ty, Florida: (DescriM real property sufFicisntly for identification, including street and numMr, if known) See Exhibit"A" attached hereto JORGE F. MURGIO and MARTA W. MURGIO, his wife owned by of a tots) value of .Ninety-two thousand One hundred----.....dol~r:ls -92,175.28••.•_-•-•._•_•1 • Seventy-dive and••2~71~0 - of which there remains unpaid 3.,•502 .98.....-••••••••.••..••.--••••, for which amount he claims a lien on the above described real property. He further says that lienor furnished the first of said labor, services or materials on ..April 3 , 1979 ,19-.....--.., and the last of the same on.... MSy 5.--...................19.80..-.and (if the lien f c is claimed by one not in privity with the owner) that the lienor served his notice to owner on N~A E .....................•-•-----..-.........,19.......-.., by.....-..-.........................••............... • MAethod of Service) - and, (if the lien is claimed by one not in privity with the contractor) that the lienor served s copy of his notice to owner on ---•--•---------------------1J.~A.................................-....-.....................................................................---.-...... )Contractor) on--------• ..................•-•-•--..........................-.......-...,19.........., by-...-------.-..-.....-.................................-...........--...... , (Method of Service) 1 and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy ~ ~ N/A of his notice to owner on (Subcontractor) .19........... by....---.....------......-.........---•------•-------....................... . on t (Method of Service) t ' ......Skle~. opt...Goc>,z~txuc.G~ax>< ! ~ 'enor i fey..... - - --Agent Y ".~,n .day of Sworn to and subscribed Mfore ms this-_--......_/~_ ` ' • _ - ~ _ ~ - Notary Public ~ © s ?'lris lnsltu?nr~rr~ prrpor.•d h_1-: Scott M. Kenney, Esquire l~il _ i /rll~,.~,~ 515 South Indian River Drive re61 az =~~1~:,, tss' ~xw ~ Fort Pierce, Florida 33450 ~ iv v4 ~lnr1pv