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145 - CONSTRUCTION LIEN M <br />('71 <br />> Jacob North Printing Co., Inc., Walton NE 68461 <br />r) a C-> (f) <br />M <br />CID <br />M C33 --J <br />? C) 00 d O <br />co <br />N <br />X M <br />00 <br />C�) <br />D 0) <br />CONSTRUCTION LIEN <br />200001361 <br />a-f C&Lt 1�7 <br />1. The real etate subject to this lien is: - <br />2. The person against whose interest in the real estate the lien is claimed is: <br />3. The name and address of the claimant is: <br />C-- <br />4. The name and address of the person with whom the claimant contracted is: 11W AA <br />W'J� Vi%44 <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 />-7'e <br />6. (Complete one of the following) <br />-Z --"The amount unpaid, whether due or not, to the claimant for the services or materials is $ <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 3 <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />Signature of Claimant <br />Subsribed and sworn to before me this day o <br />TAMARA D. HUFF 1 Notary Public <br />Comm. fib. Mard 29, M <br />(52-147. See 52-148 for amendment; 52-149 for assignment; 52-137 for recording time; 52-154 for discharge or release). <br />