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514006 N-
tu n» MEC~u-r~cs' RAMCO FORM 120s:
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Betorsms.theundersignadeuthority.pe~sonsllyappesrsd.~Old :o~st Lirrhtinu :enter. Inc'
who, being duly sworn. says that he is ths lienor herein or the agent o( the lienor herein, . .............. .. ....... ..... .
~old ~;oaat Li~!~tirx..:enter. Inc.
. ... .. .............. ......................... ..... . . .
(lienor's Neme1 ~
~ wnoseaddressis..1~J04 3outh 4th_ Street., :aort_.Fierce ~ Flori~?~
Ilienoi s Addressl . _
a~d that in pursuance of a contract with.. ...-usto~ _~ious_inc~ S,ysLe*^s ~. I,nc . ~
.,
~~Oh ~nterpr~se ~ci.~ r^ort F{erce,.Florida 33450 .
. ........... .... .. . .
lienor turnished labor, services or materiais consisting of: (Describe spaciatty tabricated materials separately)
I
LiQhtin? Fixtures ar_d surn?ies ~
on the following described real property in ....... ......~t......j :u r 1 e .. . . .... . . . . . .. .. County. Florida:
(Describe ~eal p~operty sufficiently for identitication, ir~cluding street and number, if known)
1?_0~ S.'~`. ?~~ sh~re a~v3.
r~rt St. Lucie~ ~lori~a 33457
Lot 1, 31ock 237, Section 2f3
ownedby.....='~.2•. ~ '~"rs... Leo.. F_. 3urke
........ . ........... ..... ................... ..... .. .... .. .. ... ... ........ ..... --
otatotai~ei~eot.~.even_~?'~ndred fifty-seven a 2~/ln~ aona-sIS....7.1~.•.~~......... .
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of which there remains unpaid S..... ~.~7..'. ~~........ ......... ......... for which amount he claims a lien on the above
described real property. '
He further says that lienor furnished the first oi said labor, services or materials on . ~.C t!`. ~°T
_ ......
.... . . . ... .....
~Oth .-.. ,19.~ C..., and the last oi the seme on ..'-. ove~~er 21L. , 79.~ n. ., and (if the lien
is claimed by one not in privity with the owner) that the lienor served his ~otice to owner on .. ~ A?'~'.~~?'Y ~
. y.rh .........................., ~9...P1.. by......... ;:ail.................. ....... . ............. ...... ........ ......_...- .. ...... .. .. .
(Method oi Service)
and, (it the lien is claimed by one not in privity with the contractor) that the lienor served a copy oi his notice to
owneron ...~ust ;~. _:;ous i.n~, . S1-.ste:~s,~...Irc..
..._..... ........................ .. __.. ... .. .. ....... _ ......... . .. .... ......
(Contractor)
on.. ~?ar.a~.r~-...5t?: ..19r1..-•br - -~--...=:;~i.1...
................ .... ...... .......... ................. .............. ..._...
(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 .... ... ...................................... . ........... ............... ... .
(Subcontractorl
514U06 -
on . . .... . . .......................... ................ .............. . 19.........., by ...... ........ . .... -- -....................... ................... .
(Method of Service)
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Swo~n to and subscribed betore ms this _ .__......~C~........._ ..__.. _.....day oi .......... ... •JA•w~}ae~ .. . . ._.. .'~:'..,~1n.g(.~ l,~r :..
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U Notary Publlc ~'~ ' '
7'/~is li~s~ram~w~ prrporrJ b~•: ~'v;. :~ ','!~ A! .-` `'
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:1 ddrres Hotary Public, State of Flortda at Canps ~•.. ~~~"~;~ ~;~.`•~~ ~~
G,i~!(3~~ ~~28i~ ~Y Commission Expires May31,1981 • . ,,:.~~