HomeMy WebLinkAbout0028512411
n~ ~sn -+tc~u-M~cs' RAMCO FORM 120y,
uEN uw. rs ~ua
~l~t`tl~t ~~ ~'t~n
~ ~ ~x -
~ ~ . -_
Betore me, the undersigned authority. perso~ally appeared ............... ..... . . .... .... .. ... ... .. . ..
who, being duly sworn. says that ha is the lisnor ha-ein w the agent of the lienor herein, ... .......
_ '
.-.lA/11f.S . ./1~/4~lxl.....G~l';~IF2,-~-e--~`E ... .. ............ ........ .. .. ..
(lienor's Neme)
whose address is pl[/ .. SE/~Il-~ 1~.y. .. .~~~ 11t' ........~...~ Fle~ t~. ~/~' „~.~3YfU
(lis~or's Address)
and that in pursuance of a cont~act with .. ... ... _ S~'n ~O U
_ . ~
.. . ..... ...... .. .... ...... . .. .. ... ... ...... .... .. . ,
. lienor lurnished labor, senrices ot materials consisting of: (Describa specially fabricated materials separately)
on the totlowing described real property in;P.~~t!~A~! ..r~C~ .-. ~•Q~ ~• S/h~~• ~~~y~ .0 F. County, Florida_
(Describe real property suHicie~tly ior identification, including street and number, if known)
Go ~- .36 ~Rak~,l~4y ~IAc~
q/J /rf/~N1`~~ ~c~~= ~ /~i~~cE ~`~/a• S~ La~,~
~3 ~~,~~
owned by . ,~OAIf)~~... ~/1~~..........~~~'..(.y,f .~.p...~Cl \C2
.. .... ...... .. ... ._.. . . . . ... . ..... _.. . .
ot a total value of .. . . _ _ . . . ,~i?~~:. ~ 2 .. .. . dollara (t ~~~i. ~~
)
ot which there remains unpaid S.~(~.~ ~. ~ . ...... ... ..........., (or which amount he claims a lien on the above
described real property. .
He further says that lienor furnished the first of said labor, senrices or materials on ~~. 3/~ ~`''. /~"`~1 /
'
. . ..... `.
. 19 d~, and the last of the same on ~. , 19 .Q'~, and (if the lien
is claimed by one not in privity with the owner) that the lienor served his notice.to owner on ~1~.. ~~/.~.. .~~t"~
~N , 19 aU .. by . .. f~~ /!~Jc: /,~y . . . .~r...... .. rS~A.(t)U. J _ .. . . ~/lt7 ~Gt~ ~I . - . . . . . . . .
~ (Method of Service) .
and, (if the lien is claimed by one not in privity with the contractor) that tbe lienor served a copy of his notice to
owner on
. . . . .... .. ..........
(Contractor)
on . _ .19 ,b
, . . y.... . ...
(Mathod ot Se~vice) ,
and additionally, (i( the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
, of his notice to owner on
on 5~.~i41~.
I 1981 l~P~ -6 r; ~: I 9
f~~Er~xr ~.-cu:t:~~~,
S1.lUC-F CCUVf Y.i ( d_
ROGE R PpITR~ S
C:EP.l: i:1~7~~J?T s~•~F
p; ,-,~~ .~ - r•..,; ~
. _ ~_' --
Sworn to and subscribed before me this
l~lti. lii•-ri~in.~nl ~ir~•p~~rr~l h~~:
~,,,,,,.., ~a~x3~6 P~~
ISubcontractor)
~
.19. . ..bY .............
.. ... . .... . .. .. ... .
(Method of Service)
. . .~~~ ...~J~!~-
- . ..
. Lienor
By . . . ... ... . - , ~
_ .._ ................:......- ,
,,..~...,rti,. ~.; ~ .
Agent ._;'a~~:lti'y'i:;~ .,
~
-l '~ -~ ~`
..
ti ~-
o . . ,.
, ,
~. day f ~ AN~.r~ R.y '~~ _~.~ ~~!Y
.. _.. ..._._ . . _ -
' + F-'- '~-: .. ~
~ ~ ~-.
r ~ , ~ 'J W
~~a :~ . ~, ~-- ~ ~ ~. - ~ ~
~ a~, .. t. _ a w
Notary Pub~ic' ~ 1 ~
. `~::. p~. :~,~r
~ Nofary Public, State of Flortda at (', ~Y~ ~' ~ •~~ ~ ~
My Commission Expues May 31, IS~"~f~4f ~r ="''•'
•~ .
~
~
~
~
~
i