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_--- __ --��-_-_ _ . -�.�-,�..--z � _ �__ —. _ . <br /> a <br /> -mr� = A <br /> � n n � n � ' � <br />� � D � <br /> � <br /> v <br /> b � 2 � � � C � � c...��D <br /> m � G�-� -�-1 1'�7 � O. <br />� � -< O � ,y <br /> �O w O "*1 Gp y <br /> v .� � rn F"� n <br />� � � 3 b. on p � <br />�I tn �" A OD � <br /> � � � � � <br /> a ''*' <br /> 10-3 Forms. �y t�n � � Q <br /> A (n <br /> �o-3ca� 9 9 I 0 8 � (� <br /> CUNSTR�JCTION LIEN �O 4 v( � <br /> 1. The real tate subject cy this lien is: � " • � <br /> . �S � � <br /> . � � � � <br /> th . ,� <br /> �.w�rr��sr�. ��►�4ry • � 's b1� h <br /> 2. e person against wh�se interesb�n rea esta�t e �e� i °c e ts: �� "'� ��`���j•s� <br /> -1e q o ,� . <br /> �9' b S �. <br /> �.. _ . <br /> 3. �C'l��e.�na and ad res�f ie cla II1dI��i,s�: _ ,,,�,,,�,^ ___/��Q_a�._������,Q�.�-- <br /> ' W=. __._ _ <br /> 4. '1'!ie name and address nF rtiA ►,p��nn witt� whon, rhe claimant contracted.is. �if__1-� � <br /> �s�,N. a.ti►�,�.��s. N ��,c„�.. N_��s�.------____�___��.----- <br /> 5. A general description of the claimant's servic�s performed or to be perfo med or te ials fiar- <br /> nished or to' fu'�rk she for t e ' np ve ent and th .�ntract p ' e is: 'v'" <br /> , �� � ,.�.:;� <br /> � • � , �..` <br /> c ' _ �_� <br /> c ' • <br /> T�sw � 3h �e u>� ows� Q �� `�+'� �e. aor �e <br /> The total contract price is $ rr .�3 (Q$ <br /> 6. (Complete one of the following) <br /> Tr{.,e awmount u�aid,whether due or not,to the•claimant for the ser��ices c�r tTiaterials is: <br /> �--" 'l �L�J�{� � . . . <br /> The unpaid amount is not fixed by the contract, but a good faith estimate in the amount <br /> of: $ _ <br /> 7. (Complete one of the f�Il�wing) <br /> _ T'he tirr��t,he last services �or rnaterials were furnished was `A _ <br /> The time the last services or materials were furnished has not yet occurred but is estim.ated • <br /> to occur <br /> Claim . <br /> B : <br /> its; <br /> ' Subscribed and sworn to before ►i�e this�___����of . _ 19(_ . <br /> 6ENERAI NOTARWSt�Ot.Nebt�ska <br /> I OEBORAHJ.NORMAN Notary Yublic <br /> - Ng►Comm.Exp.Sept.19,Z001 <br /> 10-6 September, 1995 <br /> ',s <br /> ;,.. _ ��Y+V <br />