HomeMy WebLinkAbout1617~
5151~9
ElA 1l11 MfCMANIC•
- UIN tAW. ~f 1qW
~t~ttm ~~ ~i~e~t
~ ~ ~_~~
~ount~ of S1= ~.i E - .
Betore me, the undersig~ed authority, parsonalty appeared .~~~' ~~
RaMCO FoaM ~zo~:
T+ ,
,:
~:s~~~ ~~e,
who, being du(y sworn, saya that he is the lienor he~ein or the agent oi the lie~or herein,
:
. . ~~1 y ~ ~. ~R i s c ~ ~o,! rJ ~'/L,..
(lienor's Name)
whose address is ~`~' ~' v• N~~.~.. ~~ . ~ i• P~E~r~,~~ :~
(lienor's Address) ~
~ • ~' h~4 ~c h,c,es ~ !
and that in pursuance ot a contract with ' , '_
lienor furnished labor, services or materials consisti~g oi: 1Describe soecially tabricated materials separately). '
c r~ 2 p~,~ ~i~ ~t ~ B~ ~e. I
y ~
on the tollowing described real property in .~~ '"~ ~~ E County, Florida:
(Describe real property sufficiently for identification, including street and number, ii known)
~o'f ~~o C3 /a ~ /O 7 [PA~ i f ,i~S -
a~ 9 r s. ~. Sa ,u ~Ia~uE~ ~•~. f- st. ~c,~ ~: E,-~/~¢.
owned by ~~.f ' l~S. - . ~ • ~~,~i ~~G
.. ... ..... ..
oi a total value ot ~ ~ ~- ~~' . ~~ ~ f~ ~~ ~~KE ~ dollars (S ~~~.~ ~ 1
p~ ~~Q . ~
oi which there remains unpaid S~ ~ , for which amount he claims a lien on the above
described real property.
, He further says that lienor furnished the first ot said labor. services or materials on
~P ~ a°Z , 19 ~, and the last of the same on S~ p f °~~ , 19 ~, and 1ii the lien
is claimed by one not in privity with the owner) that the lienor served his notice to owner on
/+ . ~ ~ . 19 ~, by ~.( A~• ~ ,
~Method ot Service)
and, (it the iien is claimed by one not in privity with the contractor) that the lienor served a copy of his notice to
owneron ~. ~~AM ~~- S
Contrector- ,
on /~~ ~ ~ . 19 ~. by ~~/V ~ .
(Method of Service)
and additionally, lif the lien is claimed by one not in privity with the subcontractorl that the lienor served a copy
of his notice to owner on . ~~~ / ~ / ~ ~~~5 ~j /~OQ.~ ~I~,
ISubcontractor)
on
/ i ~ ~
S151~9
1981 J~h 28 ?~' !?~ 23
S •'~. >~ 1!:[['LNC4'~Crit:
; • ~ . . .~ ~`,~ S~.LUC1f LOsHIX.f:.:•.
~ • HQ6ER P(`ISRA %
~ • ~ ; ~ • c~~~xc,~r.i•, ,.~~~,~i
~ ? i i • . ' (. • f ~ r ~ ~~~ ' ~ ~
~ •. 8rvorn to`and sub~cribed betore me this
~,
.C+-
~ , ,1 ~ ~ r ="' ~~ . BQr11K~~~ ~~GE ~Vi~
%'his luslntrr~~•i~l pr~~porrd h~-.
I d~lrr..s ~ - ~/~~ SQJ[ ~Gl~A/
€ ~~~-~• ~=~~~.', ~~•~
_ = f _~~:~ -
_ ~~.~4 _ -
. 19 s~, by ~
~nne o~ se ~~ ~
.
/i~i ~
lienor
By
:
i
i
#
~
;^
Agent
dayof ~~~~ 19~.
/.~i~~~I ~/'i,!''~~ f(I~
~~
Notary Public
^10TA~ /«IC S1AfE UF ~1OR10A A1 IARL I
MY GOMIMISSIQI E~tIRES Ff~. 5 t9t7 ~
~ONOE~ 11~U GENER~I INS U~'Rv-'R~ !- ~ ~
~3s/sv ,: s -~ ~
~~~_ ~ ~~: