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HomeMy WebLinkAbout0969 . . • . .S . . . _ - ' _ . ' - - - - a~y~36 ~ / IIAMCO FORM 120K NA. 1N0 MlCMAN~q' uw uw. h »aM ~ ~ ~ ' ~ B~fon m~. tM und~nl~n~d Notay Publb. P«'w~~lhl ap{~Nnd .........~~a'~c~?~ who was duly swom a~d a~?s that h~ b tdM Ii~no~ I~NoI (t!N of dw li~wr h~ninl IDELET NE? .~l.l~t.~o.... . ~~,,Q.l. -•fCl ~~:t~lri... _ ~ ~ (Li~nor's Nam~) ~ whossaddressis....y.(.~.7........t~._...~t~......... 54.~/..Q.~..L°.....-----~f..t./.~........~l.cr.9..~7f ....j~.4..., (Usnor s Addrsss) ~ y9Y / - ~ i Q and that in accoManw with ~ oo~tract wid~ Q/...? ~.0.~ f?.~...---.•- //!_~~?f..~.~ !~.0~.4.° , ...f..4..3......---rl.....w. ~v~.~.......~ .5.7..,`.:..........,~aR~... ff.....~~,c.c,~-- ..F.,~aR-.~~3Y lienor fumished labor, ssrvices or mat~rials consistinp of: (Describe sp~cialiy fabricatsd matsriais sspsratNy) ~e- LY~~~'edere~ ,~Q,~ C'r/.~~ ~IlJ A ~l~° ~~S e~ ~4/I~Q P 3~s/83 w~i~' e~i ~.~n.p Qe~ e~o~~~ o~~'~' 7~"iPa e./~ w; ~ h No ~ e.~ p•~ Q,~y'.r , C , on ths following described resi Propert~r in........~.~/..~.......:••~.l~t~ ~•-~..•-•••••-•......_...-•••-•••-•.........County. Florida: (Describe rsal propsrt~r sufficiently for identi~ication, including street and number, if known) ~o ~ f .~f ,L u e~'e. S~cfi ~ 7' 8,,~~ /0!~ ~e-~ a 7 ,~~9Q Y~ ~.J. Qv~.+~cs' S~`. ~ • . /~~A. 'i owned by......._. v.~1.. ~,1:1....14.......~".•••••l7~1~~.~...~...~1.........:.~/~.-4 .l.~..~..,~. • - - l/ ~,3 ~...r~~~t~ ~ o . of a total value of O Ilan IS~.. . . -----••.---...1 ~ f~u~nJ , of which thar~ nmaira unp~id ......~=d:'z!.._.•••-•••••--•• and fumish~d th~ ~irst of th~ it~ms on . 7 9~.~ and ths last of ths it~ms on ~-?.9. .h.?. . and IN th~ liin is claimed by o~e not in privity with ths owner) that tha lienor served his notics to owner on ---V~-~~ -----~--..........,19gJ.... b ~ ~ . Y• • (Method of Service1 and, (if required) that the li~nor s~rv~d copi~s of th~ notiq on dN contractor on by and on th~ wboontnctor..............._.....................•-••••••••-••••-._............... (Method ot Senrice) on ..........-•---.....-•-•---~-•----•---.19...........by..............- . ~l~/~°~ (Method of Ssrvice) /A ~ Q . . • - • • ..e~i% ai. - 4~~;OIQCt/Jt./. ~ ~ . . . ,ds~~ Lienor By--•-----•~ Agent ~J : f Sworn to and subscribed before me tbia_...~..../ ...................day of ~~~%C. '~1.......,..v`;::..::~.i.....x,::,,.1961.,~.. . . ~ ~ "ty ~ ~ . . - . v No ;taiy Piblic f`; f. : v, : This /ns[rum~nl prc~par~d by: ' = ~ : . : ; ; .~f[IfrPRS ~ ~y9836 ~ ~ 7~j ~ ~ l• ~ • r, - ~±F.t;'r4~b~ Ft~rids st;~qe ~ 3 ~ - , C. :~~:~o~.;~~F~~:.F~,34~ 14g3 ~S3 ~iM ~ 7 J,n ~ b.a.o ti ~+vklrfa~~~4!;l~"t ~:ii~~~a%~/0 fQ EC ~h~' t' ~r.^.~~ ; ' sc iec~t c~~;~:~~ ~ ~ ~ ~,y_ g3 nc~~~ ~ ~~r; ~ ~ . CLt.F h::F:`.ilt L r, . .t _ . ~ 8 K~~ fM~E ~