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223 CONSTRUCTION LIEN <br />n � M <br />;V <br />M <br />n <br />C= <br />7- <br />200401499 <br />CONTRACTING OWNER OR SUCCESSOR IN <br />INTEREST: <br />�.�e �t� P� o��� -qty (1 n �ar� o� <br />(Name) , e) <br />c, <br />oCAC-ki '-.) -------------- ---------- -------- <br />CLAIMANT: <br />NC <br />(Name) <br />(Address) <br />------------------ <br />(Phone) <br />(7� ABa - of t�S <br />Jacob North Printing Co., Inc., Lincoln, NE 68524 <br />C <br />REAL ESTATE: CIO <br />q,egqj t <br />CLAIMANT CONTRACTED WITH: <br />b ---- - V ---- — - --c('A <br />cf (Nam <br />I-A ---- <br />(Address) <br />15-16 ---- tk-U0-k-1 ------- --------------------- <br />-LmltOki ---- [-Anod,- ------- <br />(Phone) C (�) <br />SERVICES OR MATERIALS FURNISHED BY CLAIMANT: ------ ------- t ----- <br />------- - - ----------------------- ---------- -- ------ --------- — <br />-- -------- ------ ------------------------------ <br />-- - -- --- ---- - - - ---- -- -- ------- ------ - ------------------------ ---- -- -------------- -- --- ---- ---- ------- ------- - -- ----- - ---------------------------- ----- --- --------- ----- ----- <br />CONTRACT PRICE: $ - ----- ........... ---- -- ..... AMOUNT UNPAID: $ ------ ------- •.... .................. <br />TIME LAST SERVICES OR MATERIALS FURNISHED: .... uj - ------------ ----------------------- -- ----- - ----- - <br />State of - - - ------ <br />------------------------------ - ---- — <br />Signature of Claimant — <br />.... ........... . ---- - --- -- --- ... County I <br />On this .... day of `.A-"-i --- \ ------ --------- -- --------- --- - before me a Notary Public in and for <br />said county, personally came ... ------- -- - ---------- ------------- to me known to be the identical person or <br />persons who executed the foregoing instrument, and acknowledged the same to be his, her, or their voluntary act and <br />deed. <br />GENERAL J <br />t" <br />tq i%li F E xE.19 <br />- --- --- ---- ---- -- --- --- <br />-- -- -- <br />, 00_ '. j u!j 72 Notary Public. - <br />My commission expires the ----------- day of <br />---- ------- -------------- ------- <br />STATE OF . ....... ----- ..... .. ...... . ---- --- ------ - <br />ss. Entered on numerical index and filed for record <br />County of -- --- ---- --- --I in the Register of Deeds Office of said County the <br />Rev. 8/95 <br />M <br />Cn <br />r) <br />m: <br />cr, <br />C:) <br />CD -4 <br />CO <br />CD <br />C-0 <br />CID <br />r"D <br />C:D <br />C <br />REAL ESTATE: CIO <br />q,egqj t <br />CLAIMANT CONTRACTED WITH: <br />b ---- - V ---- — - --c('A <br />cf (Nam <br />I-A ---- <br />(Address) <br />15-16 ---- tk-U0-k-1 ------- --------------------- <br />-LmltOki ---- [-Anod,- ------- <br />(Phone) C (�) <br />SERVICES OR MATERIALS FURNISHED BY CLAIMANT: ------ ------- t ----- <br />------- - - ----------------------- ---------- -- ------ --------- — <br />-- -------- ------ ------------------------------ <br />-- - -- --- ---- - - - ---- -- -- ------- ------ - ------------------------ ---- -- -------------- -- --- ---- ---- ------- ------- - -- ----- - ---------------------------- ----- --- --------- ----- ----- <br />CONTRACT PRICE: $ - ----- ........... ---- -- ..... AMOUNT UNPAID: $ ------ ------- •.... .................. <br />TIME LAST SERVICES OR MATERIALS FURNISHED: .... uj - ------------ ----------------------- -- ----- - ----- - <br />State of - - - ------ <br />------------------------------ - ---- — <br />Signature of Claimant — <br />.... ........... . ---- - --- -- --- ... County I <br />On this .... day of `.A-"-i --- \ ------ --------- -- --------- --- - before me a Notary Public in and for <br />said county, personally came ... ------- -- - ---------- ------------- to me known to be the identical person or <br />persons who executed the foregoing instrument, and acknowledged the same to be his, her, or their voluntary act and <br />deed. <br />GENERAL J <br />t" <br />tq i%li F E xE.19 <br />- --- --- ---- ---- -- --- --- <br />-- -- -- <br />, 00_ '. j u!j 72 Notary Public. - <br />My commission expires the ----------- day of <br />---- ------- -------------- ------- <br />STATE OF . ....... ----- ..... .. ...... . ---- --- ------ - <br />ss. Entered on numerical index and filed for record <br />County of -- --- ---- --- --I in the Register of Deeds Office of said County the <br />Rev. 8/95 <br />