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rtequested by: Mike Hansen <br />When Recorded Mail to: <br />Name: White Castle Roofing Phone number: 402- 423 -1796 <br />Address: P.O. Box 22133 <br />Lincoln, NE 68542 <br />Claim of Construction Lien <br />State of Nebraska <br />County of Hall <br />I, Mike Hansen, being duly sworn, state the following: <br />Signature of Person Claiming Lien <br />Seal <br />7)kie /161(Aefy <br />GENERAL NOTARY -State of Nebraska <br />VERNON L. KITTINGER <br />My Comm. Exp. May 9, 2015 <br />Name of Person Claiming Lien <br />Notary Signature <br />�'1i ke �IU Ift9cvN <br />( r <br />r <br />r,) <br />r <br />In accordance with an agreement to provide labor and /or material, I did furnish the following labor and /or materials: <br />Roofing materials and labor on the following described real property located in Hall County, State of Nebraska, <br />commonly known as: 4012 W Faidley Ave, Grand Island, NE 68803, and legally described as: Westwood Park Fourth, <br />Sub LT 3, which property is owned by Veronica Reyes, whose address is 4012 W Faidley Ave, Grand Island, NE, of a total <br />value of $7894.00, of which there remains unpaid $7894.00, and I further state that I furnished the first of the items on <br />the date of July 20, 2013, and the last of the items on the date of July 20, 2013. <br />I hereby, under the laws of the State of Nebraska, claim a lien against the above - described property in the amount of <br />money, stated above, which remains unpaid to me. <br />Subscribed and sworn to before me this / 7 day of / S PT , R6/ <br />