Laserfiche WebLink
ISTRUCTION LIEN Jacob North Printing Co., Inc., Lincoln, NE 68524 <br />r9 <br />g ..) '4-- <br />� <br />IV � - g" m <br />B <br />e&J <br />= y• ry <br />m ,-� c _; <br />A = r <br />_- t) C <br />0.1 <br />75 r, p • <br />n ` --3 . c11 V a r *7 <br />e --.\ T6 Z A N <br />c_ri <br />T.TEN <br />07) <br />C- 4• . <br />Se l) <br />T' et <br />a <br />Q It'd <br />r ›, CD a <br />LS ' h <br />F; <br />oc4 <br />r op <br />CONSTRUCTION <br />1. The real estate subject to this lien is: Z19t <br />t , cn cJI <br />rte) ,� -..✓ <br />co a) <br />7 <br />�• <br />® <br />7loct . (y,) EUgd✓s <br />- <br />.. <br />del , . e 7 6 C,7 d / &,cntV J 7 - 17 eott,v t � , ,; , es - 4 <br />2. The against whose interest in the real estate the lien is claimed is: Ale f' Am)" <br />person <br />7,Q nn, 4 s. 1edm f/n✓ <br />3. The name and address of the claimant is JJ ,Q /e &h L . S $7T Pict./ /ea1, <br />r ,1/21/ <br />012t(-1 i S /4,)cd JJ... i <br />4. The name and address of the with whom the claimant contracted is: -- 0 0042 -C, <br />person <br />L 1, I Sf 4L i d C/ cl - 7 - - ) ' At <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 />� _ fee � $ . !' �� 01) / .. ' e4 Fee / .e.e ,, : L - /® 1 : g I <br />Y <br />Q •._.. e) 2 .o 1a <br />6. (Complete one of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ J/ 1 /96.0 <br />The unpaid amount is not fixed by the contract, but a faith estimate in the amount of $ <br />good <br />7. (Complete one of the following) <br />The time t h e last services or materials were f u r n i s h e d was D e c o b •e t 2 c 1 k , - <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />e & Ae <br />ature of ClaimantQ1,Q,o r ,, --r e-c--- <br />Subscribed and sworn to before me this d7 t i day of L idAti#11 c2- � <br />, <br />VI / J7 <br />Notary Public <br />(52 -147. See 52-148 for amendment; 52-149 for assignment; 52-137 for recording time; 52 -154 for discharge or release). <br />= GENERAL NOTARY - State of Nebra5Wl <br />PATRICIA A. RAUERT <br />.i. My Comm. Exp. February 18, 2018 <br />Rev. 9/99 <br />