HomeMy WebLinkAbout0928 b~25
r?~ ~s» wccH~Nics RAMCO FORM 120Si
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~ ~ St. I~ucie ~ St. Lucie
Betore me, the undersi ned authorit , ersonall a Tracy T. BY'3~1'~.9CJC~11b ASSOC. $eC~
9 Y P Y PPeared
who, being duty sworn, says that he ia the lisnor herein or the agent af the Genor herein. . .
M.D.M. Marble Qo., Inc.
.
(Lienor's Name)
whose address is...... 3040 I~dt~stsial 33rd St. Ft. Pie,tY,~e~ Fla. 33454
. .
(Lienor's Address)
C~rS CO Y"dtlOll
and that in pursuance of a contrect with ,
,
lienor furnished labor, services o~ materials consisting oi: (Describe specially fabricated meterials separately)
t6) Cliltured Marble Vanity Zbps
= C1~ltured Marble Panels, tub skirts, ar~d cultured rnarble
acvessories.
on the followin described real ro rt in
9 P Pe Y St. I~L1ClE: County. Florida:
(Describe real property sufficiently tor identification, including atreet and number, if known)
DY'. c'~IYl Mr'S. DdrSh2l21 ~dlWdl
781 H1.C~E.'A F21VE'_Y' I?r.
LOt 22 ~ B10Ck 1 HidC3eri RiV~er' EStateS
Pt. St. L~cie, F1. 33452 ~
~ owned by ~ M~S. Dd.~S~3n A~d~d1
2649.98 2649 98 . . y
of a total value of dollars iS
of which there remains unpaid 5.....26~4~ _9R for whicfi amount he claims a lien on the above
desc~ibed real property. ~
He further says that lienor furnished the first of said labor, services or materials on
S~t. 28 . , 19.. 84... and the last of the same on. 23 . 19....84, and (if the lien
~ is claimed by one not in privity with the owner) that the lienor served his notice to owner on
May 23 84 Certified Mail
19.........., by......._:...........................................................................
.
(Method of Service)
and, (if the lien is ctaimed by one not irs privity with the contractor) that the lienor served a copy of his notice to
owner on
(Contractor)
on . 19.........., by..............................................- - . ,
~ (Method of Servicel
~ and additionafly, ~if tfia tien is ciaimed by one not in privity with the subcontractor) that the lienor served a copy
~
~
of his notice to owne~ on
i
(Subcontractor)
,....i~~.r,;,
on.. . . . . , 9 , - '
p l~2g 1... by ...................................................~`~~c :i ~
~ ~ ~ i . ,
. ~ ~ f,,
~ (Method of Senria _ . '1"
; ~ .1:.-.
, ~ M.D.M. Marble Co Inc. ~ - _
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A/yy~/ ,
RO~ER . ~ _ ~
ST. LUC, : ~ . = ~~/,p~J/~~J-/ CJ ~L y.l.~. . ' y~~flt~._;~-, ,~.l~.- ;i
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BY .........................................r.. :~~1..h...' n- t' i•: :
. ~ ~ ' ~ ~ { ..~~s~ ~y •
. Agent ~~~.~3,:. _ r
. l~I. . _
~ ~ I •j •
Sworn to and subscribed before me this......._ ........................................da of
Y ~I........ .i~9. ~ f
. , \ • ,
. :~.r.... ~.~:1~......` C.~
J , , Notary Pub '
Tlrir Inslr~un~~n~ p~~•~ar~~d 6~.; ~ ~
•1rlilrr.~.c t-. 1 ~-'/3'~ C-'~ fjii ~r O 11R ~U9L!C ST~.TE Of FLORi:~
BUOK~~ PbGE ~ f Mk ~~M~~S~~T~ E7DID.ES M~~R t~ isa~
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