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_ `: ~ S~i990 F~~. ~9a~ ~wws Fi 71~.Oe ~l~im ~af ~t~~t ~~~ ~03p~ O~ =~ t• LLa C~ P RAMCO I011M ta0• 8efor~ m~, th~ unde~si nsd sul ' rsonall a Tn~~.^.:r~:: ~i. .3:•uht~.. .... ~ ~Y. P~ Y PPeared .......................... . .. wFa, b~i~ duly swom, says that he is the lienor heran or the ayen~ of Ihe lienor hsrein, ..- -... .. .. ~ the aftorney ~ I.nr:d~ n Cti,.tstr~, ~} ; ~n Co. . Inc. .................................................................................................... ............. .... .. ...... ........ ... ........ . ... . .. .. . .. ....... ........ (lienor s Name) ...'.~f~ :i^'~~i; TT_~?~ i~f=• r?~2'•~Bf '~.f• ','r~rn1 wlas~ addreu is.... -._ ...................... ........ ............•-. . . -. ` ..' ........... . .. . . , (lienor's Address) and that in purwanos of a contrad with .t:,_•. ,T~ ~: `r~' et• .................. ... ............... . ... .. .. .. .. . , ... . .. . .. .................... . ..... . ... . . ..... ...... . . . .. , li~nor furnished labor, servioes o- n+atsrials consistin9 oF: (Desc~ibe specially fabricated materials s~psrat~ly) i ~ ~•{-~n~~~-~_,~~~~ ii8:: ~-O•Z1 t:Gi'c ~~!'~.'::t;0i1 . _~. ~~. ~tn-~'. ~.. . ~i'.l(i ..~i::, - }:a. _ •yC :~~ i ^ nn -.r.- nr~ oF a tdal valus of.J.:......-t - .. ~ • ~ .. . . . i ~- ~ dolla~s (i --- -: • - 1 of which thero remains unpaid s--~~•`~~ , for whid~ amouM he daims a lien on_the FQ-loyvin9 desaibed real PropsrtY ~n ... ; ~• `' ." A County, Florida: (Desuibe rea) propsrty wffiaently For identification, indudin9 street and number iF k~own) ~r.;_ r : ?9 C- ~_ ~ .:ve. ~ ~~: .~~ ~2 19J :.C J ,, - ; ~. _ -~. - -~ ~~~. r _ ~ _ . . _ :~,~~~ C t:• fILECLhC~:CuF:li~~ ST.lUC1E CCL'HTY.ft A. RQGER POlTR~.S CLERK CtACL'IT Ci"~ltT~ i: ~"?~ ~ ~ t:~ 'i ~ . ~l _- - 51i990 . . _ . ~, .. . , __: • ~~ _:, ~Le- y .. . ..... ............. .. . Owned b . . .. Fle further says that lierwr Fumished the first of said labor, services or materials on "" =: . na•' ~ il@ .t• ~?:i~ ''~. ..............................-- -.. " `': ` ..... ... .....-. 19. - ~~ ~-~, and the last of the same on .......- ..... . .- .. . . .. . , 19 ., J ~ and (if the (ien is daimed by one not in privity with the owner) thal ~he lienor served his nolice to owne- on "" . ............................................ ....., 19. ... , by . (Meihod of Service) ~._..,.~_n .;:..~_-t_. ~;~..~.Ir.c... ... Uenor "'h'>:;:-i.~ i'. 3t^,~hna!'~ j~ ~ By:~°ce Fre:s;c:~ii~~~and Ger_era' i=~ana.re: 9e~ or Attornsy 'i- . . ,, . , ~ ,. ~ ~ .- . . ., .. . : . ,. ...... ~ c• ~'-ii~^ C; ; ;. . Swom tp~ a~d , • bsFore rrw this........... .' - ~ ~. ....... .. ...... y of . ~ _ c _ .. lg - - r ` ` ...... . ..~ 1 c~ . _' ~ . i . . ~! ;i~ . . 1,~ •~ t ~ S .>~~ ~ , ' ~ . r~i ~•i: •,~~• ~; ~ ~...... ... .. . . . ~` _4 , ~ ~. '~, 1 .:~~1~ ~: . _ '.y t ' • ' Notary Pu it ~ yt ,_, . . ~_J'~ • : ~lit~ ~Iu~lrnnn~iN ~~n~air,~1 /~-~: ~ ~ 1,lJn:,, BOU~XJ~~ P~tGE1GV~~ _ . _ r . - --- - - - --- ~ .,..~,~~ ~ :__ v.., ~ ~ _ -