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<br /> 3� STATE OF NEBFiA.SKA ) � i``�` ���'�`�`
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<br /> � ss. n�CHANIC'S LIEIf �p.y.. M� ,�r/r���'�,
<br /> �' �COUNTY OF HALL � ) � rir�y'�., s,,�
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<br /> ' JAMES A. VVELTOid d/b/a WELTON & SON P./lASONRY CONTRACTOR �` �rY`"�,;��
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<br /> ?' being first duly sworn on oath, deposes and says that the itemized • �'� �r`�t '�!'.
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<br /> account attached hereto is £or work, labor, skiil and materials, and � �«-� '� '�����
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<br /> �� is a true and correct account of the work, labor, skill and materials tr '��r`���
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<br /> dane and performed by James A. Welten, d/b/a Welton & Son Masonry �,.�''"K�i'��*�
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<br /> ; Contractor, for J'rimes Lee and Betty Jo Carter on property owned by , � �
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<br /> � them and legally described as: z>�,�,���
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<br /> Lot Tlzree (3), Block 1wo (2), George Lo3ns' �?r�',��`�k �
<br /> v� Subdivision to the City of' Grand Island, ,��`ss����`� `
<br /> �-iall County, Nebraska, also lrnown as 709 East �'"'�t�;, �':�
<br /> r'. 13th Street, Grand Island, Nebraska. �t�� :";�_
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<br /> �; That at the time the said labor and materials were fuz�nished and �c����� ,��"
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<br /> �, delivered to James Lee and Hetty Jo Carter, they were the owners of ,�-�ka� ;�,?
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<br /> the premises described; that the labor was performed on and the materials ���+:� �" '
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<br /> - £urnished for, r�.nd delivered at and used in said repairs to the dwelling, ,+��`,� ' �`
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<br /> �r�. the last item being furnished on or about the 25th day of April, Z978. 1,r��r t����
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<br /> ' Affiant further states that he does hereby claim a lien ; � y+ x�-�s�'
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<br /> F, on said dwelling for the full amount of the balance of the account, m,�: s ���,1
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<br /> i� to-wit: The sum of' ONE THOUSAND THIRTY SIX and 50/100 DOLLARS ($1,036.50), v ����ja�;i
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<br /> 3. together with interest thereon as provided by law.
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<br /> FURTHER AFFIANT SAITH NOT. -�'` "�+����
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<br /> t� �.�r� tia �;� s _, 'SUBSCRIBED'in �y presence and sworn to before me this --�'.� �'`. ' ?'� �
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