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MMINIII■••■• <br />cs:1■ -' <br />03— <br />c=4111■1 <br />(77 1•■••I <br />03■1■11. <br />(Dare■man. <br />CONTRACTING OWNER OR SUCCESSOR IN <br />INTEREST: REAL ESTATE: <br />674 /Yea 1? .6 <br />2 ) 4 <br />(Name) (Ife <br />Ar IC L. <br />C 4b5 ....CeC Af, /c/e1 Z17, .7.0 74 e <br />er** e/ MI /1 Co,. <br />CLAIMANT CONTRACTED WITH: Rie"‘kors:A- <br />CLAIMANT: <br />/A.e.z.) <br />(Name) <br />(Address) t?0 60) s e", ,2 <br />■010.4,— <br />I. d°°- <br />(Phone) Self .771 / <br />SERVICES OR MATERIALS FURNISHED BY CLAIMANT: <br />.16.. de...e. eehti / 2 - <br />deed. <br />CONTRACT PRICE: $ /043, 22 AMOUNT UNPAID: $ _ <br />TIME LAST SERVICES OR MATERIALS FURNISHED / (16 " 94 / AA A 1 . 0 51 1 <br />State of /14, <br />said county, county, personally came <br />SS. <br />County/ <br />On this f9a. day of <br />CONSTRUCTION LIEN <br />,xist <br />persons who executed the foregoing instrument, and acknowledged the same to be his, her, or their voluntary act and <br />GENERA. NOTARY - Sate of Weft <br />ROBYN R. MAYS <br />Comm. Exp. Apd 3. 2022 <br />a <br />r.D commission expires the day of 4p)I <br />STATE OF <br />}SS. <br />County of <br />/ <br />ignature of <br />D.se.644../e. 117 <br />(Name) " e zq <br />(Address) <br />/0,2- - 73 2 0 <br />(Phone) <br />1 79 1 .'‘ <br />, c 2Jaie4 before me a Notary Public in and for <br />to me known to be the identical person or <br />otary Public <br />Entered on numerical index and filed for record <br />in the Register of Deeds Office of said County the <br />day of . • • at .. o'clock and. minutes. M., <br />and recorded in Book of at page <br />Reg. of Deeds <br />By Deputy <br />