HomeMy WebLinkAbout0579 SU4084 ~ ~
FLA. fYe7 LAWe IIAMQO FOAM 1>l0•
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Before n1e, the undersigned authority. personally appeared .
who being duly sworni, says that he is the lienor herein or ~ the agent # of the lienor herein
' t attorney ,
(Lianor s Name)
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whose sddreu i=... /..+~c u.. ~L``...- _ ,
(lisnor s Address)
and that in pursuance of a contrail with-...-.. -...v~0~'~9.1V~.~ta.~a.~.~n. ,~y~ •
lienor furnished labor, services or materials consisting of: (Describe speaally fabricated materials separately)
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of a total value of.--.~~.~-.C1t-~u•oC. - ddlars (S ~ V ) -
of which there remains unpaid s _ ~ ~ ~ ~ , for which amount he claims a lien on the Fdlowing
dssvibed real property in-- County, Florida:
(Describe real property sufficiently for identification, including street and number if known)
190 QQi 20 r 3 , I
- illy[' crE CLL. t f~
` RGGER f'CI ~ R.:i
CLEhi{ CEF,,;I CC"fi~
I ~'~s. ~ 1j?'a
~ v fir. rc~~s. ~obee~- 5U408~
Owned by..........~1 . .
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He further says that lienor furnished the first of said labor, services or materials on -
19•~and the last of the same on 19 DYand (if the lien
is daitned by one red in privity with the owner) that the lienor served his notice to owner on
----........~o.. ..............,19 .~by-.. Ce~~ e~ w~.A ~
( (Method of Service)
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g By _ .
Agent a Attorney .
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....................................................day of r.~ G ,
} Sworn to and wbscnbed before n1e this. . IJ ~
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Notary Public" ~
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