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FLA. 1967 LAWS
FS 71J.09
t~i~tim ~a~ ~t~~t
wwMCO Fo~M ~~r
~tuts of ~lnrida ~
~ou~ of Saint Lucie
Bsfore ms, the undersigned authority, personally appeared Ri Chard B. Hel l strom
who, 6einy duly :worn, says that he is the lienor herein ~l( ~~~~~~ ~ iiKif~XOb1i~6X)EJiNd(i(,
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Richard B.....Hel_lstrom,., d/b/a._ _Nellstrom and Associates ., ._
(Lienor's Name)
Whoss addreu ~s.....Sui.te. 202_, 117 South Second Street, Fort Pierce, Florida 33450 ,
(lieno~ s Address)
and ~ha~ ~n pursuance of a co~~ract w~ih .. Narrison...H,. Wea.x~.r, Trustee ,
lienor turnished labor, services or materials consisting oF: (Describe specially Fabricated materials separatsly)
preparation of a preliminary project evaluation concerning the engineering
aspects of developing a proposed residential project on the subject property
oF a total value of .Six hundred ninety-two and 16/00------ dollars (S 692.16 )
of which there remains unpaid 5692.16 , for which amount he daims a lien on ~he following
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desuibed real property in $t, LUCIe Counly, Florida:
(Desaibe real property suffiaently for identification, induding slreet and number if known)
In Section 14, Township 34 South, Range 40 East:
the South 150 feet of N 1/2 and N 50 feet of S 1/2 lying East of A-1-A; and
the South 150 feet of N 1/2 and N 50 feet of S 1/2 lying West of A-1-A; and
the South 200 feet of N 250 feet of S 1/2 lying East of A-1-A; and
the South 200 feet of N 250 feet of S 1/2 lying West of A-1-A
and
In Section 15, Township 34 South, Range 40 East:
the South 150 feet of N 1/2 and N 50 feet of S 1/2 lying West of A-1-A --
less N 50 feet of W.14.65 acres of NE 1/4 of SE 1/4 -- and S 200 feet of N 250
feet of S 1/2 lying West of A-1-A--less S 200 feet of N 250 feet of W 14.65
acres of pE 1~4 of SE 1~4.
Owned by . ar.r son H. l~e ver, Trustee
He further says that lienor furnished the first of said labor, services or materials on OCtObe1" 27
................................... ......, 19.~~~, and the last oF the same on December 15 .., 19 ~, and (iF the lien
is daimed by one not in privity with the owner) that the lienor served h~s nolice to owner on
................. . .... .. . .. , 19 .
~~...
~ 1981 HAR 13 F'; ~~
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CLEnK C~FC!;:' C".::r,.
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, by
M tho Serv~ e ~~ ~,/G~'~/l~
S ~
~I8110r
Sworn to and wbscribed beFore me this..
S;~U:3~ti5
By
13th .day of
/7,r~ /,~~~.:r~~~~~~~ ~~~~~~~,~„f 1~;~ R:ichard B. Hellstrom
1,/,/~,,~ Suite 202, 117 South Second Street
Fort Pierce, Florida 33450
Agenf or Altorney
Ma rch
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