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2. The person against whose interest in the real estate the lien is claimed is: <br />3. The name and address of the claimant is: 50,P1 11u 7` <br />4. The name and address of the person with whom the claimant contracted is: T,,— /V11- 401 - <br />ZgQ <br />5. A general description of the claimant's services performed to, to be performed or materials furnished or to be <br />furnished for the improvement and the contract price is: <br />r <br />rw�r ti 7` <br />6. (Complete one of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ ",0( <br />The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ <br />7. (Complete one of the following) <br />The time the last services or materials were furnished was }'%'ve T)),' J CJ�U <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />r <br />i <br />`Signature of Claimant <br />Subsribed and sworn to before me this day of <br />�I 6ENERAI NOTARY-We of Nebraska < y C -A, <br />STACEY A. RUZICKA Notary Public <br />My Cep1Dt. UP. May 10, 2003 <br />j (52 -147. See 52 -148 for amendment; 52 -149 for assignment; 52 -137 for recording time; 52 -154 for discharge or release). <br />145 - CONSTRUCTION LIEN <br />M Ci <br />D Jacob North Printing Co., Inc., Walton NE 68461 <br />C <br />-" <br />r, <br />rn <br />n <br />Cn <br />� <br />O �-I <br />CD <br />-�-e <br />n <br />s <br />LD <br />)> <br />z <br />N <br />� <br />�rn <br />O <br />p <br />s i <br />,q <br />V, J� <br />�: � <br />O rn <br />O <br />rn <br />f'-" <br />LV <br />�> <br />o <br />)� 010493 <br />� <br />D <br />C <br />D <br />C� <br />CONSTRUCTION LIEN <br />jV <br />M <br />vv <br />aeo <br />J-oAe5 zOCuS%- <br />) <br />1. The real estate subject to this lien is: <br />t/5,� <br />ITO <br />Z V f ��' S 4 �J ; <br />�n.�, i<< i <br />rr. <br />s,r l c -A ra/ <br />l/r2 <br />2. The person against whose interest in the real estate the lien is claimed is: <br />3. The name and address of the claimant is: 50,P1 11u 7` <br />4. The name and address of the person with whom the claimant contracted is: T,,— /V11- 401 - <br />ZgQ <br />5. A general description of the claimant's services performed to, to be performed or materials furnished or to be <br />furnished for the improvement and the contract price is: <br />r <br />rw�r ti 7` <br />6. (Complete one of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ ",0( <br />The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ <br />7. (Complete one of the following) <br />The time the last services or materials were furnished was }'%'ve T)),' J CJ�U <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />r <br />i <br />`Signature of Claimant <br />Subsribed and sworn to before me this day of <br />�I 6ENERAI NOTARY-We of Nebraska < y C -A, <br />STACEY A. RUZICKA Notary Public <br />My Cep1Dt. UP. May 10, 2003 <br />j (52 -147. See 52 -148 for amendment; 52 -149 for assignment; 52 -137 for recording time; 52 -154 for discharge or release). <br />