' ' �t,,-�— --_<ir ,'.£ .��..t�� � ( t` �__..��7..��u�-��-'°`o�m'a��ic�, _ _--�.—,-�.s+,,�,•'�'ry--."�,e __ __.___.
<br /> - ��! �c�:s`..�.,�.�c��. zt ---. - -- -r = -�' �;`. - - � ... - ._ - t-'�-� _ . - x . — - - .f--t c -.
<br />- ; -P�`t;�"p1�P -• G� 4 �4- ( � r , t� a t �,�- f�.� _ �y �.4 � s t . tt f t � h�.w . ..�� . �- -.
<br /> ��. �1�•"r -a� 1,�F- .�-�-E- .n - o ti� _ `y 5 �� G !�� h ,`� ..i yy. . ,`c t� ,f .*,!;'TS't r c r�.
<br /> ',:,�r,� : �� .e. _ ,Y,. � � .� a�c c F. - ax ;,f.•C._. ...--5�;
<br />. of s �. . �: t-- ., r�
<br /> '�?,t' ..f .��� . . . .. ' �.s�- _
<br />� r-. . �-�,;a • . . � - . , ' - '
<br /> . � . � ' . . ' ,�-�.n � � • ('i � . ' ����a�1G.'a4�+`�ti�IC�s�� � .
<br /> . � �' �P '����1�41�f. '�4 '� f... ��
<br /> t-. , <'o _F. � , . � d� . . � _ a :p r..-
<br /> �` � � � �, ,� .
<br /> t r � v�. ' i , �� .�j: �.�' c�� , �
<br /> ' . . . ` - ' , , ,� � � � s�s "4�ic°� .. . �� ♦ w4-
<br /> �'� ' � � � �r�.
<br /> ,( �t- 4- . . . ' ,. ` ' .> 'A` � �"�' . .� �� .� .� � Y,..
<br /> ti. � . . . . .ti •� � �,�•
<br /> , ,,•� . � _
<br /> •.t _ � � : ; to�s ° � �� . �a _ =-
<br /> . :n p� � � �� -.�..�,
<br /> , ' � � � � .:a.
<br /> � .. � . .. ,.. _ ,• • • � • • � .. � • . ., � : _ .�;� ,�='°:
<br /> -- - - -" ��� ���5 . �.i�iV .. •-- -- � -`-.� L
<br /> , .� � . �
<br /> t � . BiZL
<br /> . ': . ` � ���� 1�� ��t�r�h_n� . ��'tn� �stan�, �1�� � , ��,:
<br /> i_ ����.��. -- — -- � �- - - _� � � �t�� �d�� � �.-- �
<br /> , . . . ��,..p� �? � ��+��K 3 ��1Ct�rt��s ,�!'� cv�t � ntcs k ���:
<br /> � �� -
<br /> 4 . � � li y � � �d-� CQnSt�'Uefi�n,� --
<br /> ..�: ' 2 The geison�ainst wliose interest in the r�al estate�e Iien is claimed i� ; __ �� _
<br /> � F 4` C��f ��'�r►�-�-h . . � . _ _
<br /> r � �. ��������� �j�"�er U�Or� P 0. �ox 1�3�;___�-_ __.
<br /> _ � �r�r,� �sla�¢ N� �_ ��8oa�. . , _ � � � � . . --_
<br /> �:, . �;z�,,��et���c���: L'°������'dor�: � �
<br /> ' 4. Ttne namie su31 adch�ess of the yarson ��O t _-
<br /> 7��� �,aAr+ Srh�h '�a� � 5 ��hr �a?, 4rr�nQ �s�anc� 1u� ��.::_:�—.�.
<br /> ,��,..
<br /> • �� r
<br /> ' '.�; � �j gen,erat desmgt�on d�the claimangg servic�es P¢rf6x�ned to.to bs performed or�a:'�teats fismiehed a�ta�
<br /> . - � � �usnish�cl far the ix�aprm�anea��and the oantsac.�prioe�se , . , �,.. _
<br /> ,:�:�� � . � ,�. � nS Rie�R fA �t'�u7 Y e f�tmr 1,Ui�� Gt� P.It�''i��, . . : - -
<br /> . .., . . . . . �
<br /> . t � . .
<br /> . , :i��:�r - � : , . ' —_-
<br /> 6. (ComFlete orYe af�t3ze folioa�) . ' � r
<br /> , . � � � a or� . , �
<br /> - �The amannt napaid,whether c�ar not�,t�tbe claiman6 for thg serv�c�e ar m�ter.iats is� � ._
<br /> . �Th.e:ar�aid amowit is not fis�?bY the oontrad,but a good faitd��tamate in the:amowat of$ . . � � _
<br /> , . � . . � ��� ::
<br /> . s 7.:(ComP2ete one of t�e fallowing) �
<br /> '� � '� ��-t�l--9'7 , . � .
<br /> „ , were fumish�was •
<br /> . ",�,��Th�"e�ne the last,sarvioes ar utatarisls . . _
<br /> � . .•.. T.he time the last serviaes ca;�aterials were fanaished.�as noL yet aoc�rec�i�u�is estia►�d to oocur . � � � .4
<br /> . .. � � � . . .. . . — .-
<br /> �r _ . . � � .. _ ' __--
<br />_ , r;: .. � � ' ' , . . . � .
<br /> . . . . . • � � . . .. '�"'3-.
<br /> . i . , . • , s,���f Of���1mS�'� _ ' t ,
<br /> ,. .. . . . �
<br />- .. • • Nti �-
<br /> .. � • ' • ' - F-
<br /> . :, _ �
<br /> � �.� . �'� . � �- ' ,is�. �_
<br /> � Snbsii�eti and swam to bsfore me this �/ day of_...,.
<br />_ . . � . � � o -a� � _
<br />_ GE!lIRALNOTAAT•SWeotNebrasMa Na�y public --
<br /> : , ° ��N�,°,'s v�i 2oan - �;
<br /> . � � ��:�1:� ,• _.
<br /> - ..:�� .'
<br />=- (5�19?.S�52�148 for amendmenh v�149 for as�nment;5�13?�orreoanliAg.time;5�Iii4 foi disch�rg'e orreleaIIe}.
<br /> ..;,, : �
<br /> .' . .' � �:
<br /> ___ .__.� .._.___ ...
<br /> . . ; . : � � � � -
<br /> ... � Rov.9195 . �
<br /> �
<br /> y .
<br /> , • '
<br /> • . __ 1
<br /> ' '. � n...�.��� . -:....� .... ... . . . �.-�T
<br /> . •...i.� K
<br /> ����
<br /> .�.�
<br /> . � . •..
<br /> .....
<br /> . . ^^�2Ir.:�--�_.._._...___._ . . . •. . . . .�
<br />
|