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<br /> 1. The real estate subject to this liea i� Ys r��r T�`r�,D SJc�D�u/S,o,�
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<br /> 2 The person against wh�se intereat in the resl estate the lien is daimed i� `�J L �v Sv�
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<br /> 3. The name and address of the claunant i� �t�� ,c I cz� C..�t►tid-e r �� ,+4
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<br />� 4. The name and address of the peraan witt�whom the claimant contracted i� �Q''''�C a S ��,
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<br /> 5. A general description of the claimant's servioes performed to,t�b�p�'��or materisla fim�ished or to be
<br /> furnished for the improvement and the contract prioe ia
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<br /> 6. (Complete one of the follo�:ring) ;/
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<br /> The arnount unpaid,whether due or not,to the claimant for the servioes or tuaterials is$ �,
<br /> The unpaid amount is not fixed by the contract,but a good fait.h es�mate in the amount of 3 SFfO �'d
<br /> 7. (Complete one of the following} .
<br /> The time the last servioes or tnaterials were fumi�hed was _ �� +�- !'���
<br /> The time the last servioes or t�aterials were fumiahed has not yet oocurred bvt is estimated to occur I
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<br /> Signa of Claimant
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<br /> Subsribed a,nd swom to before me this � '1 �_�y;�f,� , 19�q.
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<br /> (5�147.See 5�1�8 for amc�edme��,52.149 f�r assignmen�5�137 far recording time;5�154 for cfis�axge or release}.
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