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t1 <br />C <br />Z <br />=r -1v <br />r = VN <br />Requested by: Mike Hansen <br />When Recorded Mail to: <br />I. 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 />I, Mike Hansen, being duly sworn, state the following: <br />nn <br />= D <br />c,) <br />U7 <br />int <br />C) <br />r- <br />7-, <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: 517 Saturn Street, Alda, NE 68810 , and <br />legally described as: Lots One (1) and Two (2), Prairieland Subdivision, an Addition to the Village of <br />Alda, Hall County which property is owned by Michael G & Andrea S Jones , whose address is 517 <br />Saturn Street, Alda, NE 68810 , of a total value of $ 8,860.00 , of which there remains unpaid <br />$6,360.00 , and I further state that I furnished the first of the items on the date of September 23, <br />2019, and the last of the items on the date of October 10, 2019. <br />I hereby, under the laws of the State of Nebraska, claim a lien against the above-described property in <br />the ount of rriojney, stated above, which remains unpaid to me. <br />Signature of Person Claiming Lien <br />Subscribed and sworn before me this <br />Seal <br />GENERAL NOTARY -State of Nebraska <br />NICOLE CLARKE <br />My Comm. Exp. August 22, 2022 <br />0-6\ <br />t (,e i Se�1 kir S cN co <br />Of White Castle Roofing & Contracting <br />Name & Title of Person Claiming Lien <br />day of lair tk iN , Oa..0 • <br />Notary Signature <br />N <br />O <br />CZ) <br />N <br />CD <br />O <br />log <br />