HomeMy WebLinkAbout2727 ;o;ulil t0: (Ar1C105~ SYh•i~~fiiS~O itirtl~O ~I11fYjOQi~ ~u 1N0 YECMANiC{ ~ RAMCO fORM 120'~
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rr~~s Instrum6M Prepar~d by: ~e-) ~ # Total = ~
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~~rnperty Appraisera Pucol Ida~tificat+on (Folio) Number(s): j
St16Cf AlOYE TWS WIE FOR ?ROCESSIMB QI1TA SMCE A/OVE TMK LIME Fpl R~IIOwB O~TA
~ '90 F'B P 3 :45
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Before me, the undersigned Notary Public, psrsonally appear~d l..e-~ 1~1 1~
who was duly sworn and says that he is (ths li~rtar h~roinl4the apsnt ot the lisnor henin)
(DELETE OAIE)
~~e ~u-~ ~uS~ Q~ ~.UCt,~, - C~? u~y , ~nC-•
1Lienor's Name)
whose address is - / ~ ~V - l ~s ~ W~ erc;~ , ~I ~~1 `j ~ ~ ,
(lienor'~ Addressl
and that in accordancs with a contract with W~, l~~.I t~.~ ~~1.` V~_~- . ~
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~ lienor furnished labor, services or materials consisting of: (Describe specially tabricated materials separately) ~
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.-~--~r -~-q b1c.~ -Io ~ te `k~-~'i, L ~
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~ on the following described real property in 1~-~~~.~_. County, Florida: ~
M ~Describe real property sufficiently tor identification, including street and number, if known) ~
~ ~ C 0~ S. }-~c. r-1.nc n lZd . ~
t SGC f TwN'~°J6 1']~35 S/~{a ~ ;
~ 1 l 3 5 y O Frorv~ N t,~ ~.o r b~ 5~~~y o~ 5~..~ ~ ~y R~+.~ S 2 ro0 For' '
~ 'Po 6:~l~' R ~ n 5 2 f
~ (o ~ -t"1-~ ~ i 1 S . TF+ 2 i . ~ F+ ~ 'Tl+ w
~ ? 7 S~-~. Pa 4- Lc s s w 4 5~~- L~
owned by i. ~j . t J ~ f . 5~1~~ . ~~1.75 ~o. ~ 0
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~ of a total value of ~N~_ ~iv/1(,~fCd s~ x'~ N`~C ~dollars IS ~O ~ rCD.$-}
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~ of which there remains unpaid S......... ~ end furnishsd the first of th• itsms on
~ ~ 1.' O . , 19 . and the iast af the items on ~ . 1. ~ ~ _ _ , end 1if ths lisn
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is cfaimed by one not in privity with the ownerl that the lienor served his notice to owner on
~
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,19 ,by .
(Method of Service)
• and, (if required) that the lienor serveQ copiss of the notica on the contractor on
s by _ _ _ _ _ _ . . , and on the subcontrsctor. . . _ . _ _ _ _ _ _ _ _ _ . _ .
(Msth~ f Service j~,~ M~~n ,,,n
on ~~/f I I~~ i11 j~~l~ ~ 0~~~ ~~~1~ i/~~ . 19Q~ , by `~'/1~'~Q~ ~"IJ~tJ'1 ~~~~IJ~G()' ~-IrA11~~
x (Method at Service) _
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Swom to and subscnbed bef rr~_tAis,,,~ .?:3~:~V~~~ day of 19 ~
;:~W. - !~3 DiXON, CLERK CIR. T. / ~ '
BOOK FACE e County, fl , ~~~lt
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