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hi <br />>NSTRUCTION LIEN <br />ocl <br />Subscribed and sworn to before me this <br />GEKRAL NOTan• Slide aPieb►eea <br />PATRICIA A. RAUERT <br />My Comm. Exp. February 18, 2018 <br />CONSTRUCTION LIEN <br />4 13 15-4deded 4,t°e <br />gnature of Claimant <br />4 ) gfiev7 <br />Notary Public <br />Jacob North Printing Co., Inc., Lincoln, NE 68524 <br />m <br />rt Z <br />a —I <br />nz ,, <br />_C ` -4 m <br />-� r CJ <br />C.n <br />cry <br />▪ N <br />' o • fri <br />f 0 <br />0 <br />1. The real estate subject to this lien is: ZoT TAR e,G (3S /S /ock Fibk (8') /3oNAN Riui /,add. <br />T the (: /Ty a J' �'semad SsInklciAwLL CouNTy A/.t . /57L id :s'11, ST <br />2. The person against whose interest in the real estate the lien is claimed is: 7A.e FS'7'A7e. <br />1I/ RM o F <br />W ANA 5" C De of SCE/ J4 Aid JNe <br />u, l it om pSo�l <br />3. The name and address of the claimant is: ' d 8 Reif rL AS; J. t e. all 4,39a.1 <br />r9 Qiaad ms /AA)cd, Ne, bcIol <br />4. The name and address of the person with whom the claimant contracted is: 0 .B Pe iJ7 L sue <br />s7 oi9aL Rd, Qt14cI .D / #a d, Ale b ef-cy <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 P el+io U e T2 ►IS a / (' p p, 2 EL pe 7.2 /R a1 <br />.ceavide, Cleat.), P4y Elee?2oc h >/J Foe '7moAri $ 7»1, <br />L, �a,v' J £3,11 ream c!'T <br />201407891 <br />6. (Complete one of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ 4,y93. -26 <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 Dee-en 404 � ' r a0 <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />day of J.- 2/e %v/./. <br />r : m A <br />f"" c) - n <br />Cr) <br />T' r' � T <br />T M r` J N <br />r r> C <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. 9/94 IT <br />