HomeMy WebLinkAbout0714 495366 ~ ~
ru? yccw?M~cr RAMCO FORM 120?,
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esfors me, the undersigned authority, personally appeared ~/e-'C-~~~ . - - - - - ~T
who. being duly sworn, says that he is the lienor herein a the agent of the lienor Mrein..
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(lie 's Namsl
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whose address rs..........iQ..Q..~~......... ..l..~~...... ~........~!..C.L.-~..~
(lisnor's Address)
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and that in pursuance ofacontractwith.....~U~..o.l .h.-.-...~.•••...... ..~../1-.~*1-r~.0
lienor furnished labor, services or materials consisting of: (Describe specially fabricated materials separately)
L a~oa~ ~N~ ~~~i~L.s
on the following described real property in ....~V U,~.................................... County. Florida:
(Describe real property .sufficiently for identification, including street and number, if known)
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owned by.........1-•.I..UL•~•D.../ .......1...~.(/a-~~..Q
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of a total value oi~~.~.~.. /~.~h~reY.... 7.!..la... .......~.n,.°~wdollars lt ...Q.../.~i....'~
j of which there remains unpaid:.........~`~53.e..~ for which amount he claims a lien on the above
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described real property. L
He,f/urt~her says that lienor fuprnished the first of said labor, services or materials on ../~p -
.~IP'!!.--.-.. -/...7....... ,19...d~, and the last of the same on.,,~'r.~~.~.........~........... , 190...., and (if the lien
i is claimed by one not in privity with the owner) that the lienor served his notice to owner on
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. ...u~~~... 5.-- ...,19~Q.., by.......~lT~-L -
/ (Method of Service)
~ y p ty py of his notice to
f and, (if the lien is claimed b one not in rivi with the contractor) that the lienor served a co
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e
owner on
(Contractor)
on ................•--.19...........by----------------...-.
(Method of Service)
and additionally, lif the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
of his notice to owner on
~ 495366 (Subcontractor)
c
,19........... b .
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on
(Method of Service)
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S1. LIICIf. CWiitY.it A. h~ ~/.E:~.J. --L-,O... '
ROGER FOITRAS ~i4 •
CLERK CIR~UR COURT Lreno~ : -
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By ~ ~ . .
a
z Agent Y~'~~j ~
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Sworn to and subscribed before me this ..................-..-.--................day of ~(,L 1 ~
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i AT Notary Public' - -
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