Laserfiche WebLink
�� .,......� <br />� rRU��id t,fEfV <br />�� <br />e <br />� � <br />N �� <br />0 �� <br />� - <br />� �� <br />N - <br />�� <br />�� <br />� <br />� A[i �� <br />ti <br />2 ' c..,. <br />1 � � � � , c� <br />� n � n i l o -- � <br />.�y 7� V� c> �. <br />� Z �� � � � <br />m a'' <br />�:� � <br />� � � �� <br />� � <br />(:Oi�11�'I'�tt3C'TTOPI LIEN � y - � <br />C <br />''� � - C�o <br />� <br />� <br />c� cn <br />o -a <br />c a <br />z rn <br />---1 <br />� O <br />o T� <br />T z <br />z rn <br />A � <br />r :i7 <br />r � <br />� <br />� <br />v <br />.� � <br />� <br />N <br />Y. The reaJ estate eubjecE to thie lien i� �� ��-tC'`� � `�' �� �� � ��- !�— ��. <br />, � ��/ � � C� � �J {�-� �6 � � <br />2. The peseox� a�aans� whose fnte�.at in t�e sesl e�4ate the lien as elaiaryed i� �� ���[ ��.� �� <br />3. `I�a nara�e and address of t�e �laimant a�: �� � � � � �- b b (�C� �� �-� c� ( <br />��; .� �'� r��� 0 r���s( � 1-� �����3 <br />4. Th� n�me aazd eddrese of the peravn witlt wh�ni the claimant ontt�cted ie: `- r! q �- � <br />5. A�eneraI d�aiption of th� c3aic�cY�a�'� sesvices performe� tv, #,� be performed or matEriels furnish�d or to be <br />�nrnish�rl for the i�pro�°ement and the e�antr�et price is: <br />6. (Complete one of 4he following) <br />� � � o�n urapaid, vs►hether due r not, ta the claimant far the ser�►ice� or materiats i� S�� <br />___�Q tI Ca��� ( l���es��� . � <br />The auigai amount is not fix�d by tkae coz�traet, but e. good fait� estimat� in t�e amourat e�f S . <br />7. (Complete on� of the fouowing) <br />'The 4ime t�e last servioe� or mat,�rials w�ere furni�hed waa . • <br />�'he tame tlie last �ervic� or materia� were fumigh� h�e not yet oocurred but us estim�ted to oocc�r <br />l� <br />Signature of Cl�mant <br />Suber�bed and eworn to before me thie _�/� � �y Qf ��°'� <br />GENERAL NOTARY - State of Nebraska <br />TERI J. FREDRICKSON ptg�r Pu �C <br />My Comm. Exp. Feb.14, 2013 <br />�(52-147. Se� 52-1�48 for amendmen� 52-149 f�r a�signment; 52-137 fvr reoorcling tims; 52•15e! for diacharge or relesse?. <br />� i �v � Rlda.�a ��umb� n <br />I S� <br />1��8 Pcp c�' r. <br />Hutfroon arod Fet6on � Vltolf, WaBton NE 8�161 <br />Gc�c� �s��n�, IU� C��� <br />