HomeMy WebLinkAbout1293 49x7550
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Before m.. N» undersigned authority. pers«1au+r appe~
who. beirq duly sworn. sacs that M is tM lienor herein or the spsrrt d the lierlw herein. .
ILienor's Name
whose address is------~-; ....~~-....-.i.~~X.......a7 ...............~----.r-.lG_.LC..~./...~.-...~./.5~.........
I~ierlo?'s ndar.Q:s~ 1
and that in pursuarlrx d s contract with . - - . ,,~r. -f~..•i.Flt>w A.Y...... Qfv. ! t Q!.!~. C.!1'~~S ~/1-4a
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lierwr furnished Icebox, services a materials consistirp of: (Describe speciaNll f~sbricsted Jmaterials separately)
SAID `tor u.St TOa-~ ~a-~:Dw E Tv~ S~ tC w~r~ _
onthsfolbwingdestxibedrealpropertyin---.-•--..cJf -.....~G~~..-•-•-------•------- County. Florida:
lDescribe real propsrb sufCrcient111 for identification. indudirq street and rarmber. it known)
s Ic. ~u.r,.: 1 ~ res ~ ~ a.nc~
f.oc.A t ;oN (.01- ate, (il«~~ srS , f.(,nj i- S Potir sf
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owned by: - - - - - -
-Z
s_i
L ~ T~ ~ :f~.-..o.N ~-.-ddlar: (s --3.7.3~~.,-----
ofatotalvalueof .'/.~il.~/.y--.S~.ueq-.llu~nr~r.-..
• d e-Z
of which there remains unpaid t s~, .s~. • . . . . : . for which amount he claims s lien on the above
described real property.
He further says that lierar furnished the lust of said Isbor, services a materials on - - . - - • - . . . . . . . .
I 79
~~.-----il{i__- --.-.,19--~ardthelastdthesameon__..----~ ----....79..~~.andlifthslien
is claimed by one not in privit
fr with tAe ovm»rl that the lierar served his nonce to owner on . . . . . . . . . . . . . .
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(Method of Service)
and. (if the lien is dsimed b1l one not in privity with the oontractwl that the lierwr served s copy of his notice to
owner on _ . _ _ . tl'uar pu~.!/'1.~ - - Q `c~ ~
on.. - .19--fr~.a? -5-----..Pony-l-n.l~.-...--..~v~-c-c.-.
- - - (Method of Service)
and additionally. (if the lien is dsimed by one cwt in privity with the subcontractor) that the lienor served a copy
of his notice to owner on . _ - . - . - - . _ _ _ .
49'7550 (Subcontractors
.
I _ - - .19 -....b1? - - - - -
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on
. -Q 27 i~= Q4 (Method of Service)
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RCGER~PgT~_1D Lienor ~i'.~i:-.t . _
. 1 Agent i , ; ~ S `;r. '
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Swom,to and subsuibed before m. tlws d - - - - - - - - - - - - - - ~ ~ • - -
d
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Notary Public ~ e~~'`
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