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I I <br />145 - CONSTRUCTION LIEN <br />0/i' /Vf /ff / <br />4 <br />GENERAL NOTARY -State of Nebraska <br />CAROL E NUNNENKAMP <br />M Comm. Exp. Jan. 13, 2017 <br />CONSTRUCTION LIEN <br />otary Public <br />Jacob North Printing Co., Inc., Lincoln, NE 68524 <br />1. The real estate subject to this lien is: L d kort.6 ei � U ,1(. /4&f4,T <br />jv;/e,VA WJ13 /4 f / ',Cfiaih jA (�/i� ///4M, /rf'39 /iJ / /id/ /J/Je �.D'1 , A/J <br />2. The person against whose interest in the real estate the lien is claimed is: 4Bg deA/y-i hA0-46 - <br />3. The name and address of the claimant is: t / / ®. 1, . /-L,A 0/i. J/J N/171Aiin^f i 94/ <br />4. The name and address of the • rson with whom the claimant contracted is: 6fig..//f.► , Aa <br />0' <br />5. A general description of the claimant's services performed to, to be performed or materials furnished or to be <br />furnished for the improvement and the contract price is. <br />Afl �/JM,41/76 /lam /2d gAt, <br />6. (Complete one of the following) <br />Y . The amount unpaid, whether due or not, to the claimant for the services or materials is $ 10.777° <br />The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ <br />7. (Complete one of the following) � ` <br />The time the last services or materials were furnished was `�I l-/�1�r1 /,-,,i5; ;24/d. <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />Signature o aimant <br />Subscribed and sworn to before me this k-k Y day of _•- ` • • . , aSTA <br />(52 -147. See 52-148 for amendment; 52-149 for assignment; 52.137 for recording time; 52 -154 for discharge or release). <br />Rev. 9/93 <br />