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70 <br />N c <br />Z <br />rri X, VI <br />- n <br />ri • • <br />Return To: <br />Kim Osborn <br />Weathercraft Co of North Platte <br />PO Box 1949 <br />North Platte, NE 69103 <br />(308) 534-3480 <br />Grand Island, NE <br />Curtis L & Jennifer Lynn Wudtke <br />3. The name and address of the claimant is: <br />Construction Lein <br />2. The person against whose interest in the real estate the lien is claimed is: <br />201500646 <br />1. The real estate subject to this lien is: Brentwood second sub LT 19 blk 3 <br />ry <br />C_1 <br />CrJ <br />rT <br />Et) <br />--1 <br />C7 3> <br />N <br />rn O <br />Q t F� <br />U1 <br />z rn <br />t► ca <br />r r - A 4 <br />CD <br />(1 <br />to <br />Weathercraft Co Of North Platte, DBA Duff Roofin . PO Box 1949, North Platte, Nebraska 69103 <br />4. The name and address of the person with whom the claimant contracted is: <br />Jennifer Wudtke 3107 Brentwood BLVD Grand Island, NE <br />5. A general description of the claimant's services performed to, materials furnished for the <br />improvement and the contract price is: <br />replaced roof <br />6. (Complete one of the following) <br />X The amount unpaid, whether due or not, to the claimant for the services or materials is $6764.22 <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 />X The time the last services or materials were furnished was: 10/3/14 <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur: <br />State of Nebraska <br />County of Lincoln <br />Subscribed and sworn to be <br />3,x .�4�uke <br />Signature of Claimant <br />Weathercraft Co of North Platte <br />.49 da <br />11011141.1. tames <br />WOMB KB ORINgl. IMO <br />Notary Public <br />,20U . <br />