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! ty {� V Huffman and Felton & Wolf, Walton, Ne 68461 • 221 -A— MECHANIC'S LIEN rLien claimed by: ............ A - p .....il ....... 21 ....... .... ... ..----- ...- -• - ..- ........- °. ----2 000 Preisendarf Plum6in 8 Ht INC Wayne & Marvel Forge ......... .. ........ .. ........... ........9 Agasnst:........... y..........---......... ---.....................- °---.. .X...... Address.. 1104 W Oklahoma -Grand Island Ne 2847 Golden Rod Drive- G- ..I..._..Ne 68801 ra Dr. Cr. --- ---- -- ------ ----------------------------- ---- --------------------------------------------------------------------- State of .._NEBRASKA Hall ss. county ! Aunt Greta Johnson - Preisendorf Plumbing & $tg INC ............. being first w ' , duly sworn, on his oath says that the foregoing itemifed account of work, labor, skill ----- *..._ ............................... ..._...... -... materials, and improvements is true and correct: that same were done and performed and furnished by the undersigned Wayne & Marvel For e . x. for the said..--------- y---------------------°- -- ............................. ...... ... ...... ........._.................................................................................... underaz Verbal ..................... .......... contract ........ ..... ------------------------------- ---_._......._........-----......---------------------------_- for the...... - ---- Ins_tal.lat. ion------------- ............ .......... of a ..new.. wa.ter.... pump............ ............................... l.................... .............................................................................. ....................................... ......................._....... ........................................... ....................... Lot # 1 Meadow Lane 4th on the following lot, piece or parcel of l and, vic:` ......... ........... ..................................................................................................... ................................... ......... .... ............ ...°•---................................_................................................. .......................... - °-•• ..................... .......... . ............. .............-------------------------------- * ..................... . ------------ ....-.. _...------- .................... ...... •---......-- - - - - -- --- ................. .......................................... •-•--•-° .................... .•--..................- -----... .. ..................-.-........................................ ....I....._..................... That at the time said contract was made and labor and materials furnished and delivered thereunder .................... Wayne & Marvel Forgey was the owner of said premises' •-•---•---......---•-------•-• ................... •--............................ _..... ---- - - -- ............................. ................ ....................................................... ............_.............._ . ... ............................... -- ............... ........................................... ............• •- ---............ - - -- ............ ............................... -- .._................................._. ......................._....._. .----...-• ...... ............................... .... ..............................- .................. - .... ..................._........... - .....--------...... ........._..................... That the date of the first item furnished and delivered was .. ............... .2.- 2..7.. -99 .......... and the dateof the last item was •-- -- --- - - -•-- - ---- • - ....--- ----- -- ---- --------- - - - - - -- -- ------- - Affiant further states that said labor was performed on, and materials were furnished for, delivered at, and used in said building or premises on and between the dates specified. That the prices changed therefor are fair and reasonable, and that there is now due on said account the sum of * *Six- Hundred -And- one -and 12/100 ............. •Dollars, that said' ---- - - - - -- ........................... ------------- •- ••- •--- •---- ....---- - -• - -- --- ...--------- •- - -• - -- ................................................ ......--- ............. -------•----• .... ......... ...... .......... . . . . .• .................... ................... .......... ............................. -- • - - -- . ..... - .- ..._....... ................................. ........................ ...................................... . ..... ...... , __•.- ..- .....-- .............. -.................. ... .... claims a lien on the said premises for the full amount of said account, to -wit: The sum of $. 6. 01. r ..12 ........................... ............together with interest thereon at the legal rate, from the ...---27th .... day of-- -Jan........ . ° .................. ...............21000 ...... and further afrant says not. Greta Johnson - Preisendorf Plumbing & Htg INC WNEPA NOTARKState N� be raska •• ------ ------ - - -- - -• -- ----- ...... ---- •------------- - - - - -- .....--------.............._. .....•--- ...---------- ......... . PATSY A KALKOWSKI X.. ........-.......... ------------------------ • - -.../. . �CM' I� X4.2m Subscrib •n m pre a and sz�n t before me this.... .�ST ...:.................... dayof • ..... ... . .. ..... / ....... 4... .. .............. . ... °-- -- ........................................... ( See reverse side for instructions ) Notary Public. STATE OF ...................................... ............................... Entered on numerical index and filed for record as- County in the Register of Deeds Office of said County the ............................................. ............................... dayof .................. ............................... 19............, at ................................ o'clock and .............................. minutes ......................M., andrecorded in Book .......................................... of ........................................ at page.............. ............................... .............. ............................... ...........................Reg. of Deeds By.................................. ............................... .........................Deputy