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145 - C RUCTION LIEN M > Jacob North Printing Co., Inc., Walton NE 68461 <br />fqNST -n r7l Cn <br />M Cr) C=) C> --i <br />0 = =D (= >- <br />> <br />M <br />=0 O o <br />-. <br />C., czz � -n <br />- C:> — <br />o CD <br />3> co CD <br />M rte-- C) r- 3> 17\3 <br />U) <br />CID (n <br />CONSTRUCTION LIEN CD <br />1. The real estate subject to this hen is: �Ae -TLf Oes)-filn FO � -- N) -C —10'i Cf <br />P1, — <br />"To I,; I, k- A LL <br />ip 1-i,\t e- }'the G <br />da. <br />t <br />2. Ae agai sPwfiose inTerest �ri ihe reW estate t e lien is c aim is: <br />perOn <br />3. The name and address of the claimant is: : <br />/Z) 7 C <br />4. The name and address of the person with whom the claimant contracted is: <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 />Ld 0 ez?l� bul'lej� 5�f",C64,d-5 <br />6. (Complete one of the following) <br />oc-> <br />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 <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />A GENERAL NOTARY State Of Nebraska Signature of Clairr*Knt <br />II STACEY A. RUZICKA <br />.5 My Comm. EV. May 10, 2003 <br />Subsribed and sworn to before me this day of <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 />