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HomeMy WebLinkAbout0985 _l ~ . '~~31.5~0 RAlAGO fORM 120%'~ flA. iM0 MECHANIC~' ~r U!N IAW. f~ )11.Oi ~ ~ ~ ~ ~ ~ 8~tor~ ms, ths undsrsignod Plotery PubUc. Pa~sonally ~pp~A~sd ........{~.Q.~?.`~~'•~'t...`!.'X'.Y.~?:% : , ?vho wss duly swam and saya that h~ is (th~ li~nor Mrsin) (tho sqe~t of the lianor herein) ~ 3 (DELE7E UNE1 i `i t'VQ,1...~'.i:Ll.i~:C?1~! ~a-..~:~,C.~ ~ ' (Lianor's Name! ; ~ 4 . . _ . , ~ , , , • ~ ~ J~~ i~ t r~~ c~rce I' ~ er id~~ 1~~~ `~h ~ whose address is.....=..?.~'.r....::.4.~~...~..:......}.........e...-..-:.:.........a , (Lienor's laddress) ~ t and that in accordanc. with ~ cuntract with ~?.u:1c;... ~ . 1 1 ' ~ . . . . . , l) rT':r;1C.~'•SS...}i2::LVE'.~....-:.~Y'.t--•=~t..._ ~ L1C7,~~ . =.;1~~~ .....7......... ~ ~ - ~ lienor turnished labor, services or materials consisting of: 1Describe specially fabricated materials separately) 't f ;iOU~;~1- !.=7 ~ `~'0;--:;llt: ~ l_~'_iC2 2_? : ?1 Li"1t711~F" fOT' t?t1C1? t~ (lr~ ~ 1I!CZLICi'! S~~ ~ ~s ~l ~ ~ T 7, 1 ..:l~l,.l ?.'.l_":: ~.1:; {J~ • { 5t . : ilt; ~-e ............_Count Florida: ; on the tollowing described real property in Y. ~ ~Oescriba real propurty sufticiontly fdr identificatioc~, includinfl street and number. if kno~n+n) . ~7~) ;'T'1.riCf;SS ri'_LV~~ t?~Vel =z~I'=~~ .'OI't :~'~i,e ! 11C1.°~ {~4r~ ':Ot: ~ I ~ i~_~.GC~: ~ ~l7 ~ ~e~_~~ :i_i.VE:I' :_~Z';: ~ :Jtj'. ~ !.1.1C1E,' I:OLlr~ i.~}~ ~ ^1_orici.•3 • i1P . ` owned by . U~:~. 11 ~ " "....:..J.......,...... " " " f'l~i~-.--(• • . '-1~...r.~,-; C~i.... , .r.. r~•" v, s._.1;~`.~_? :+~t~'_~ .;~:::I: ..:.~1'.;. ~ ~ 1 ,L7',: •.~~i > of a tatal value of dolla~s (S : , iT ~~~.J ~ l)~~ i = of which there remains ur.pa~d g end furnished the first of the items on f~. :3_:'C!i ~ li~..... ' t llfl° ~ '1 ~ - . 19 end the lest of the ~tems on ~O C............, and (if the lisn is claimed by ona not in privity with the owner) that ths lienor served his notice to owner on ..~.==9. t...l~~:.: 1.:t,G.~~? ' 19.........., by................---................................_.................. . . IMethocf of Service) end, (if r~quired) that the lienor sarved co~iea of th• notice on the contractor on ( C t ~i1~!_ i.C ~_l; ~ E: j ~ by and on th+a subcontractor.............................................-~---.................... (Method of Ser~ice) : on 19........-~• bY•---~--~--..........................-~--~-~- . - , (Method oi Service) '~'r~; o~: ~~].u:::~~? n~:, ~ r.c . = ~ lienor - , ~ . . . B Y ~ ,<obel'~. ~'r5'o=~entl~er'_ . ~ :r~ ' . . - l ~ ~ ...............day of "t~_1~9:~.~.c~ Swor~ ta and subscribed before me this....... ' 4 ~ ' ~ ; .~....1_1^.!`' ~ r~d - ~ ~tar.y Putifig . ~ 'y vj= Tltis Inslrtentc•nl prc~parc•d h}•: Notary P~i~!it. Staterb~'~~r'.dq " Ad~lrc~ss ~ ~ , , t_ , ~ r~1y Comm:ss;cn Ex rtf 2~1 y~~f ~ eT'Aq ~ , i~', ~ Bc~:e. ~r~~ Gu~ e,;A m,~A1~:r..;~e.••~ t: . . . ! . 1 ~ i ~ s~Q 16 P 3 ~a6 ~ x ? _ ~ FtLEu ~ ~ t< , . . _ ROuEF ~ ~ ~ S?. ~uC;E ~ ~ . - . 600K~~~ PAGE ~ ~ , ~