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�� . .• :��j1 _. A Y��TrtsR71�1�s1'we+" ______—_— -!"_—'_ <br /> ` ��� '� __.rl1Y�tl'�Yl "311'�•{�`'Ll'".i[�._ y��-i .._ _._ <br /> � �:7fdhY 1JI.�IN'• uaJe�![' .• <br /> v7 yµ —_ <br /> ni:��v�n... <br /> _. ._�.. __ � _"_.. <br /> .-_.. <br /> �``�'�" Rt J�oob Nath PrMkInO Co..Ino..W�Mon HE d8461�-_ <br /> 11_ '«'..«.T��+ � � - - <br /> lJ � � <br /> O � = N � '� ,c � Cfl <br /> _ �� � ,� � "y <br /> � �� � � � � <br /> �e� ' rn � '� � � <br /> o� � .� <br /> � � cra �+ � w <br /> .� n � m � <br /> � .,0 w <br /> � �,�j ��' `a � 3 g �' W <br /> � tn N � ` <br /> �� ..� � - <br /> � .�nuT � N � _ <br /> �� „ • (;UlViflltUti11V1�a�aua• �, � <br /> � <br /> `S <br /> � tW �i� �lw'/� 5�.�;an 8?"a�,�s��n 9 NdTi��..�ta <br /> 1. The real estate subject to thie Hen ia: � ��� �- <br /> � W �} � �p�1:M. F�ia��tou��t1L�'��A� 'l7°`�'Ticv��ur`� �I�SCt'l�� Oh�+r ���9e �� <br /> 2. The peraon againet whose intereet in the real�te the lien ia claimed is: <br /> � tr <br /> �� z5 S. 5, �41 Oo,n;���... a'''�' C'o�wlec 1.d•..�ew�►�o�c• 3Ei? t�r s� P,xc Do��'P� � <br /> �____y' —�l-�"'�# <br /> 3. The name and addrese of the claimant ie: <br /> Qpv:S u.t'V ��� �l r u <br /> ��3 �t1 SV-`�'C Yv.�w �� �O�1ib�Q�E. ���� <br /> 4. The name and addreee of the person with whom the c.laimant oontracted is: <br /> 4:11 ��e� <br /> lo'�So�� �` � DoK� ��E. <br /> 8St3 <br /> Fi. A 8eueral de�adPtion of the claimant's eervtoes perforaned to�to be performed or materisls fl�mished or to be <br /> fl�rniehed for the improvement and the contract prioe ie: <br /> . 1 . _0. �� c..�l..�:.�!cie�-a.1��!� <br /> � Su.�'v .�a — w e wev-e w�i"c.r� �t+�+���... . �.�_.�- - . <br /> 1►yqS'�eaulru�►- W�.Wtna o�b� 1.n t �� � e • l►tt Cnux0.�-Q'�o�r <br /> Su.rVe,�.�or W4� �r • <br /> 6. (Complete one of the following) � <br /> �The amount unpaid wh�►�'due or not,W the claimant for the servioee or materials is$ <br /> '�13�3'� . <br /> The unpaid amount is not fixed by the oontract,but a good faith eetimaGe in the amount of$ • <br /> 7. (Complete one of the following) <br /> ,.�The tirne the last eervioea or materials were ftumished was ���; �gQi� . <br /> The time the last services or maf,eriab�vere furniehed bae not yet oocnrred but ia eetlmated to oocur <br /> � � <br /> Signature of Claimant <br /> Subsribed and swom to before me thie �0.Y '19�' <br /> q�l MIM��M IIM�II <br /> ���� Notaryr Pub'c <br /> _ (52�147.See 62148 for amendmen�b2-149 for sesignment;62•137 fnr recordine time;52•164 for diecha�ge orrelease). <br /> � - <br /> � _ - <br /> ,_ � <br /> . --T" �' Rov.9/95 �i <br />