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1 <br />145 - CONSTRUCTION LIEN ;0 <br />Jacob North Printing Co., Inc., Lincoln, NE 68524 <br />n M (A <br />2 D p O <br />M = to ~' o C', o <br />cn <br />C Z M o <br />rn 'i <br />*, C11 -,� z !� <br />CD <br />� <br />N r'rJ CD <br />A U� <br />CONSTRUCTION LIEN cc <br />cn <br />n <br />200M668 <br />1. The real estate subject to this lien is: ;�S': 3 / E -4r,- +` <br />12. The person against whose interest in the real estate the lien is claimed is:�.S��iln.9rzlpN <br />i <br />3. The name and address of the claimant is: r- <br />4. The name and address of the person with whom the claimant contracted is: <br />j <br />C�'M �/s..�� /» /�/� /pA /�f/� lril7.t X �s % •i: G�- �nt�l�- .��t..'d�e; �.�= �ct:3�.3 <br />i <br />5. A general description of the claimant's services performed tgJo be performed or materials furnished or to be <br />furnished for the improvement and the contract price is: <br />1 �c� <br />i <br />6. (Complete one of the following) <br />0 <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ '`�`f 'I` ° f <br />The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ <br />I <br />7. (Complete one of the following) j <br />The time the last services or materials were furnished was -f�- <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />f <br />i <br />Signature of Claimant <br />Subsribed and sworn to before me this day of <br />GENERAL NOTARY State of Nebraska���. <br />III STACEY A. RUZfCKA Notary Public <br />My Comm. Exp. May 10, 2003 <br />(52 -147. See 52 -148 for amendment; 52 -149 for assignment; 52 -137 for recording time; 52 -154 for discharge or release). <br />i <br />