99105374 - Laserfiche WebLink

Browse

145-CONSTRUCTION LIEN �? rn N Jacob North Printing Co.,Inc.,Walton NE 68461 � �,, � �� R .X� ITI G? � � � , � � C.D c� u> � CLJ o —1 � � C -b-�1 � ` � � � � . � � � � '� O 1 ., s � p�`�• � O T1 , � � � � �, , �� ° �-`� —� v � c� rn � r- � � + o r �. 617 (� CONSTRUCTION LIEN � `'� " � � 99- 1��53'74 ,� --� :� � � � � 1. The real estate subject to this lien is: Z S �/6 W�s f �c� � ��e�.� 7� �A�� 9-`l fi �i�i�( � r?s-�-� �.d ;` �L Z � 2. The person against whose interest in the real estate the lien is claimed is: Qc o� h� �les s 3. The name and address of the claimant is: T�,..� /�� ,�ti 2 +� o S" �l; �r ,^��,-r� c i Q T ,�� FZS lLo�p 4. The name and address of the person with whom the claimant contracted is: ��°cJ� .^ ry h�PSs �•� ��e �1�5 � "I/A ./� � �/'e n � �1 /!/P b��✓ 5. A general description of the claimant's services performed to, to be performed or materials furnished or to be furnished for the improvement and the contract price is: �T�`�'g /di S �1ct /o�� Coa,r�a�� •Y�ii� �/�e o—� �� 6. (Complete one of the following) '� The amount unpaid, whether due or not, to the claimant for the services or materials is $ � g'. ri'� The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of$ . 7. (Complete one of the following) ' �The time the last services or materials were furnished was �'�/ �l - P� . The time the last services or materials were furnished has not yet occurred but is estimated to occur � � i i ; ��'"��-�...-, � Signature of Claimant I I I Q �, i � Subsribed and sworn to before me this z�� day of ��`-�'1-- , 19 �. i ; � � ' I Ct� � I(� r� [�Ct� � �GENERAL NOTARY•State ot NeDcaska =; I i�� PATTIE G.YANDA Notary Public `� i My Comm.Exp.Nov.+1,2001 � I I ; (52-147. See 52-148 for amendment;52-149 for assignment;52-137 for recording time;52-154 for discharge or release). i I � i I i i i i i � , i � �I