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<br /> � :.; �(r:(�t154�9_ :::- . . .., ,, . .. -. - ,, , _ , :.. �
<br /> '� � 221 A—MECHANIC5LIEN (Revised 1962). Th HuRmao G<ner„�Supply H ve Liucoln Nebo� ' % � �
<br /> ' _.j: ).___ ._..�__._.. ___.._._.___ .._.-- _ _ _ __ 1 ___.
<br /> ` Se tember 11 76
<br /> � Lten claimed by ....._. .....P ..... ....... ...... .�g....... i
<br /> ; i � ........�om:Ellis.•-.........._ ........•--.........••-••--...... Against:.Walter.IioltzAnd:A�nea.Holtz�............... . � ,:.
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<br /> �i � Add�ess Shelton{ .Nebraeka 68876 Rt. 2�.Box_186� Sheltont.NE.688�6 i ;
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<br /> I ! t ...2�l..:. Dr Cr. i
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<br /> , _______ llg6 sq.__ft.__of concrete floorin�_4!�_dee� ______________897 �
<br /> ---- ----------- ---- --- -------•------------- � :
<br /> ij � � 75� per sq ft.
<br /> i. ------- ------ --------- ---------------------------- --------- --�------ ----------------------------- (
<br /> i, Tom Ellis labor_on buildiag_______________________________ _ 64_00____ - ( Ii
<br /> ---------------- ------------------------- --------- -•--------- ---------------
<br /> i i -------�--------�---- ----------�--L913B_�AbAL_AY_Gx_�meY..--------------------------- ---•----------•----------7_G 4Q---- � '
<br /> �; ------------15.y_arde_of_concrete_paid_direct------------- --------•-----------•-358-50------ � "
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<br /> � --------------------- - Balance Due 526 50
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<br /> !'' i S1nle o/.......Nebraeka...•-Countti' I
<br /> ��ss. �� � ��f � � �
<br /> .Buffalo �
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<br /> , � AfjwnN, ._•_--...:..__._Tam.Ellie....---........................._._......................................................----........------...................., being hrst �
<br /> � duly sworn,on his aafh says tkat tl:e(aregoing iferni�ed account of work,labor,ski(1........_................ � '
<br /> ..............................
<br /> materials,and improvements is bue and correct: that sau�e u�ese done and perfosoxed nnd furnuhed by the imdersigned I ;.
<br /> i ';'• • Walter Holtz and Agnes Holtz
<br /> x ;: for the said...:..._.............---...._.....-_................_......_.................................................------_........................................................_..... . ; !', '
<br /> t ! ' under a' .......................Q.ral.......................-•--•---- contract..................................................-•------.........--..............................__.._...... i :!
<br /> j, 'I � Jor tke'.....................Pre�aration ' concrete floor ' ',
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<br /> � ` � --.........................._•---......far...a.garnge---............-----�--•--...----•--------.............................---•---...-------...................................... . , '';
<br /> ', � on Uie(ollowing lot,piecc or pasrel of land,vis:'......S..utheaet..Quarter of SQction_18t.Township .9.North,� ;'
<br /> _ ; ' Rage,_12_West of_..the 6th.P_M x Hall C.unty� Nebraskax ......... , '
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<br /> l ' � Tkat a!fhe lirae said co»t�act.ras usade and la6or and �naterialt(urnished and delivered thereunder............._.....
<br /> ._......Walyer Holtz and Agaes Holtz..............•-•---........................._-•--......................was thc oumcs o(said premiser' i �'
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<br /> Tltat the date o(the j�rst item furnished nnd delivered u�as........................••--•--....----.._...---................................ and fhe I ..
<br /> s : i datc o( the last ifcm .ear..........................._--.....-_.........__.....__--------..............---.......-----..............._. � ,
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<br /> ; i A jjiant(urther states Niat said labor zua,r brrformed on, and »mrcrials:ucre furnuhed for, dclivesed at,and used in � I;
<br /> � ' aaid building or premises on and between the dates specifird. ;:
<br /> j � That tlie Qrices diarged therejor are fair and reasonaLle,and that tliere is nonr due ox said account the sum of � !'
<br /> ; � .Five,Hundred�.renty-aix,.ztnd.50/100------ Dollars, that said° �
<br /> � ...._...._. ...__._ . ........ ................................................................
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<br /> �. ' � ....._•..........._... .............._Tom.Ellis
<br /> ...._.............._..._..._..
<br /> � ..._..._ ...._...._......................._...................................................clainu a lien on the said premiscr for the/ul!amaunt o( ' '
<br /> ffi ' i• � raid account,to-wit: The sum o 5z6•50................._to ether wiUi interert fhereoa at the le al rate, � '
<br /> f$........................................ g 9
<br /> '' � �rom flie.................._----dcy af._..---•--......__......._........._....._......_......,........._..................,�tg............, and furtker aQ'innt rays not. � ''
<br /> . ' 1 ..............---............---.........._'.'?�,t..L......�.:��`s�.........._.__..............................•-••-___........._ ;
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<br /> ; ; ihb�M� ..••••••..........................._................................._........._..._...----...-•------------................................
<br /> ,; � �`���LR, ppNi Subscribed in my presence and sworn to before me this........_.._llth
<br /> � �
<br /> ., � � � -. M11yComm.Fxp.AuL10.197� da o Segtember,�. ..... _ 6 ' :.
<br /> Y f..........._................. .. .. ..+��. .. ... rg......7.._..
<br /> /'�.��; . ....... .�.6:5.1., .."•"'" .._.'"""'_"'................... .� '.
<br /> (See reverse side[or instructions) � � � Notary Public. •;;�
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<br /> ; j 3TATE OF..._._._..._..._..._._......__...............................��. Gntered on numericui index and fil�d for record ' , I �
<br /> � � County , in the Register of Deede O�ce of eaid County the ;�, �,
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<br /> � ......._......._......dny of........._........_........_........_.---... 19............. at........................_.....0 clock and..............................minutcs......................rf.. ;
<br /> 1.' I nnd reconded in Buok............._...._.._.._._....._....oL_._...._..__......_.............at pnge..............._............................ �
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<br />. ......................._.................._...._.._...........................Reg. of lleeds '
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