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CONSTRUCTION LIEN <br />-S -5a <br />1. The real estate subject to this lien is: C C_ 1 02 <br />:7j-\(Aa1)S '10c1 !Sub 'lS' x I5► S ' C n� 3 81� t-} <br />2. The person against whose interest in the real estate the lien is claimed is: <br />WaA� P A«� ► �� <br />3. The name and address of the claimant is: PQi lA ()(Wk) kA—g- 6+1J1'1 (,I 0;e 7 ii' a) K!�_ <br />4. The name and address of the person with whom the claimant contracted is: BTU �,br\ <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: 0a0y owol ICI Gtr, <br />eI h-lnal debw a J1QV(kl �S vu�tu�� �1Ptu) oorklnk� Mffinfil <br />6. (Complete on of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ Iq a4 5. 9 V <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 M0. rC.11 3 \ 4 oZ % G t_J <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />, /� .6L ' rt_�Lwf <br />Sig ature of Claimant <br />Subscribed and sworn to before me this 19. —day, of r' , 1sybb <br />4 <br />Notary Public <br />(52 -147. See 52 -148 for amendment; 52 -149 for assignment; 52 -137 for recording time; 52 -154 for discharge or release). <br />GUM NOTARY - So of NihII <br />CONNIE S. BALES <br />E OCTOBER 11 <br />n <br />m <br />2 D <br />o --+ <br />O <br />M <br />�1 <br />N <br />C <br />3> <br />rn 2 <br />'. <br />O <br />C_- + <br />Z <br />t V <br />Z <br />p <br />= <br />rn l <br />m <br />° <br />O <br />7 <br />C1 <br />O <br />GG.. <br />Fn <br />N <br />N <br />c <br />N <br />O <br />�_ <br />�+ <br />x r-t <br />O <br />V� <br />_ <br />OQ <br />ran <br />O <br />CA3 <br />ae <br />c <br />r <br />CO <br />o <br />rn <br />� <br />CD <br />cep <br />o <br />O <br />O <br />200403868 <br />CONSTRUCTION LIEN <br />-S -5a <br />1. The real estate subject to this lien is: C C_ 1 02 <br />:7j-\(Aa1)S '10c1 !Sub 'lS' x I5► S ' C n� 3 81� t-} <br />2. The person against whose interest in the real estate the lien is claimed is: <br />WaA� P A«� ► �� <br />3. The name and address of the claimant is: PQi lA ()(Wk) kA—g- 6+1J1'1 (,I 0;e 7 ii' a) K!�_ <br />4. The name and address of the person with whom the claimant contracted is: BTU �,br\ <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: 0a0y owol ICI Gtr, <br />eI h-lnal debw a J1QV(kl �S vu�tu�� �1Ptu) oorklnk� Mffinfil <br />6. (Complete on of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ Iq a4 5. 9 V <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 M0. rC.11 3 \ 4 oZ % G t_J <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />, /� .6L ' rt_�Lwf <br />Sig ature of Claimant <br />Subscribed and sworn to before me this 19. —day, of r' , 1sybb <br />4 <br />Notary Public <br />(52 -147. See 52 -148 for amendment; 52 -149 for assignment; 52 -137 for recording time; 52 -154 for discharge or release). <br />GUM NOTARY - So of NihII <br />CONNIE S. BALES <br />E OCTOBER 11 <br />