HomeMy WebLinkAbout1573 ~ f
sc ~sss
y
ru »rr wECw?w~u' RAMCO FORM 120K t
ucw uw. rs naM i
~l~tim ~it~rt
of St. Lucie
Before ms; the undersigned authority. personally appeand........•g~ •••J,8me8-••HayWOOd••••-••
who, being duly sworn, says that he is the lienor herein or the agent of the lienor herein, ~
Ax.ts:c~...~.1,umbi.ng..Supp.1.y.,...xz~~..
(lienor's Nams)
whose address is.....b.O2..S.:..~th..SZreet.,......E.t.....Pierce,--.r'.los.id.a.-...33~?~0
(lisnoi s Address)
and that inpursuancsofacontractwith..:.......(~~g.tOtR~•HOUS•1Rg-••Sy8•t@ffi8•~• -•hle:•••-•••-----
-
I
lienor furnished a0fiiwt]fiT~iKilfiidCifr materials consisting of: (Describe specially tsbricated materials separately)
Plumbing Supplies - }
Copper 'tubing, PVC Plpe~ Tubs, Lavatories and other related
material as ordered from time to time.
on the following described real property in......$.t~...LUC1E••-•-••-•----•-•••••-----------------------------------County. Florida:
(Describe real property. suHicisntly for identification, including street and number. if known)
Lot lts Block 13 Section t5 I
i
350 N. W. LaPlaya-
Port St. Lucie, Florida 63452 -
- 3
owned by---.......James...Hazekamp
•
of a total value of ~41~..~iundxec~...~h.1.lCi<y.-~S+!Q...axld...u$.~.L.oQ... dollars (s ..-...132...08
of which there remains unpaid 5 ................L32•.•OS•-~--•-~-~--•---•--•. 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
i -
I September...Ots......... , X9....8.0, and the last of the same on..s.eptember...U8...... , 79.8u..., and (if the lien
is claimed by one not in privity with the owner) that the lienor served his notice to owner on
October...Zs.~ ...............~98U--..,by....Certitied...Mail----~--........-
(Method of Service) _
~ and, (if the lien is claimed by one not in privity with the contractor) that the lienor served a copy of his notice to
i
-
1 owner on .....Cus_tom.-Hous.ting.. Sys tems,...1nC .
` (Contractor)
on..October...2..3..~ - ~9~U..... by.....0ex.tai.~~.~d..Ms:i~.l............................. _
(Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
of his notice to owner. on
(Subcontractor)
on .....................~g~-~~~~..2.4....~`I~~~•2~.........19.........by....................-.................................................... F
(Method of Service)
E FIL~G lt:i: F~CGii~:l ~
ST.LUCIf CCU:~'Y,FI=. --•••Artco• -Plumbing.'Supply-,-.•lnc-.,.-.-•._-. - '
ROGER PGITFQS t
CLEF.K CIPCUiT , ut>fiT f Uenor
Fri ":.'„1 Y' Fli"' ^ ~ - 1 i.
By ~ -
~ Agent r
Sworn to and subscribed before ma this • v • 7 9. • " -
CCCC(( ` , : •
PIOT,'.R'( PU?~ fC STA'= 0,=. ~ORIDA AT U1RGE G ,1~?
r
;,t i C~.....4' rt EXMiR~ ;EPT 41.1984 ':3~r,~.
O'~di~ Ti.. L' ii`ii , U`C•~Y/RITcxS Notary Pu liar . (7 .
~his~iislrumr~nl prrpnrrd h~•: Patricia N. Clark
, Y ~
1' r
.•~d~l~.•.~~ 60'Z S . ~ th street _ _
i
~ ~ Ft. Pierce, F1. 33450 ~ '