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<br /> duly sworn, on hs`s oath says that the/oregoing itemiced account of wor�,labor, skil/...................�1�ptbi�6.__...._. ......._ n �,
<br /> tnaterials, nnd improvements u true and carrect: that same west done and performed and furnished Sy the u�dersigfsed � r ��
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<br /> on the follo:orng lot,piece os parce!of land,vi.:;a--...13.t2"'SWY,qi'1�Y��tyli�'$Q----S�t'��.r.._-$�ti,�'s"g�YerBtde-•�4er 8 , � '. 1'`
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<br /> That nt the tiuie said contract was made and labor and materiads f:arni,rhed and delivered thereunder........................ ; �: ,`;
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<br /> •-•-•••--••--•---•---------------------�_.._----•---.._---•-...------•QeeT81d.�-......-••--•-----•-•--�--..__._...---...._..was the aznner of said premises' '
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<br /> That tke date of rlte�rsr item furnished and delive�ed _.... . __._.._______________ and tl:e `; ,: �
<br /> �'°s iretszaota�r•'1'7;•-t97g•-........_
<br /> date of the last iEem was.-----••••-•••----L�C#ObeF.-2�•r--1�-7-�---�-------------------.......__...._.._........•-----...._..••---•-•••--......__..__....._._........ ; r ; ,;..:.
<br /> Affian!further states that said labor was performed on, and materials :vere furnished for, delivesed at, and used in
<br /> snid bui[dmg or premises on and between the dates specified.
<br /> Thaf the ¢rices charged ther¢for a�e fair and reasonabl¢, arid that tleere is nou�daie on said account the sxam of
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<br /> - ----•--• ................................................_......_.........• --._.....•----claims a lien on thc said prcusiscs for the full aniount of
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<br /> ` �--�5* �.?. •�-•---_------...logether wslh interest thereon at the le�al rate,
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<br /> 'iaeverse 3sde for ixstsuctions
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