HomeMy WebLinkAbout0716 y'
r?w tttcw?Nics j `~'~+~`~v RAMCO FORM 120'h
utw ?ww. rs rua
~l~ttm ~f ~i~~
~ ~ vsf ~ i ~ ~a
~ S~ Lv~~~ ~ 9 ~
~"/~c>~«
Before ms, tM undersigned authority. personally appeared ......................................r~-....
who, being duly swo ,says that hs is the tienor herein or the ag/nt~of the lisnor herein. . .
(Uenor's Nams)
whose addressis......~..f7.1.~............~~E%r....W..r~. ~ /..~r.~/.4~-.. ..~a-.~'3.'.~v
(Lienor's Address)
v '
and that in pursuance of a contract with......!l.l~ ~i0../..~........'.....'.......f...~.//~4. ~l..b........... .
tienor furnished labor, services or materials consisting of: (Describe specially fabricated materials separately)
i
on tM following described real property in........ C~.T'~.. L~ G.~'C .......................................County, Florida:
(Describe real property suHicisntly for identification, including street and number, if known)
~?cs•o%H cam' .~f : ~~S No r'Ci`o SS
~So ~iNOa/i? RS: x.07`' ~ .C3/I~ 3'y'7~ ~f S~ L~.C'~ct Sec(
/at ,Boa ~5es 3G, 36a. z`~iru 36a~~ ~cb/~G
>~coltds 1' S~. Lv c., G Go y / /C/t.. .
r
of a total value of ..~.~.°.~./Y~~ C-.~ /l.~... dollars lS ......1 ~..1..~...~...-.......)
/r 1/ (rll~ O t
Q Q s
of which them remains unpaid 5........1.-~.-o••-.'•~a--------•----•-•-•. for which amount he claims a lien on the above
described real property.
He further says that tienor furnished the first of said labor, service or materials on . .
i~/~.. , 19..!..ti,J, and the last of the same on. ..li~........-.. , 19.~..., and (if the lien
is claimed by one not in privity with the owner) that the lisnor served his notice to owner on
E
E t9.........., b
y............------~----~ ,
(Method of Service)
I
and, (ii the lien is claimed by one not in privity with the contractor) that the tienor served a copy of his notice to
owner on -
€ (Contractor) I
on_._. . -....--.....-..................19.....---•-•bY--•--•
( (Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the tienor served a copy F
5
p S
of his notice to owner on . . -
495363 (Subcontractor)
z
on _ . - . .19......... by .
C „ !f -
19€0 AUK -6 P!, 3: 33 (Method of ~.rr'
. .l
•a
ittEC Rht FC~fi~tDEO ~ ~ .',t ~
St IUCIE COJAlY,FI Il. Lieno~ '-a-' ' ~ t~ ,
f`t06ER f'OITRdS ~ _ _ _ , .
CIERK CIRCUtt CO::R,Q - .
-n / '
iIE~C,. n,,~..f:
- - _ - f;y ~ ...r - ~
Agent? ~.r•
~ Sworn to and subscribed before me this ............day of ~..f .,,ft:.:_4~ . .
C-LLti// ;
i
~r» c
~41AkY titNtlC At~t~ Notary Public
l~hi.~ lrrslrunrr•nt prrpnrr•rl h~•: Mr GDMMIi>~f~ll 11 Nay
1 drlrr•s-. 101100 1NY QfdIK 1NS . NwoE~wutNS P1G~ ~~4
1~~3
_
_ ~ _
~.~s _