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73 <br />C <br />ori <br />Z <br />rn JP— <br />N— Tn = N <br />0� <br />co <br />Requested by: Mike Hansen <br />When Recorded Mail to: <br />V Name: White Castle Roofing Phone number: 402-423-1796 <br />Address: P.O. Box 22133, Lincoln, NE 68542 <br />Claim of Construction Lien <br />State of Nebraska <br />County of Hall <br />nn <br />=> <br />m <br />U) <br />7.0 <br />rt. <br />r - <br />I, Mike Hansen, being duly sworn, state the following: <br />In accordance with an agreement to provide labor and/or material, I did furnish the following labor <br />and/or materials: Roofing & gutter materials and labor on the following described real property located <br />in Hall County, State of Nebraska, commonly known as: 3320 West Old Highway 30, Grand Island, <br />Nebraska 68803 , and legally described as: See Attached Exhibit A which property is owned by <br />Kleint Properties, LLC , whose address is 3320 West Old Highway 30, Grand Island, NE 68803 , of a <br />total value of $ 22078.18 , of which there remains unpaid $10,602.95 , and I further state that I <br />furnished the first of the items on the date of June 4, 2019 , and the last of the items on the date of <br />June 10, 2019. <br />I hereby, under the laws of the State of Nebraska, claim a lien against the above-described property in <br />the agQlounX of mgney, stated above, which remains unpaid to me. <br />Signature of Person Claiming Lien <br />Subscribed and sworn before me this <br />Seal <br />3C5*-- <br />AAXVISAA1 r , P vkeRit (-- <br />Of White Castle Roofing & Contracting <br />Name & Title of Person Claiming Lien <br />GENERAL NOTARY -State of Nebraska <br />NICOLE CLARKE <br />tit My Comm. Exp. August 22, 2022 <br />day ofvtk-w1 , 2k 01 1 <br />Notary Signature <br />ON IN3Wf1S1SNI SV 43}131N3 <br />