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223 CONSTRUCTION LIEN <br />CONTRACTING OWNER OR SUCCESSOR IN <br />INTEREST: <br />------------------------------ <br />(N a m P,)_. <br />-------------------------------- <br />CLAIMANT: <br />---------------------------------- <br />J <br />(N <br />------ -- ---- ---------------- ------------- ------------ <br />(Addr�so <br />- ------------------------------- <br />----------------------------------- ----------------------------------- ------- - - - - -- <br />(Phone) <br />REAL ESTATE: <br />- ------ ---------- ------- -- - <br />(Legal Desyription) <br />---------- -/--- 1 is--- - - - - -- <br />-------------------------------- <br />CLAIMANT CONTRACTED WITH: <br />(Name) (Zi; 2 ,/e/ L � <br />-------- ------------- ------- ------ --- --- --- <br />(Address) <br />----------------------------------- - - - - ---- --------- ----- -------- — - <br />- ----- - ----- - -------- <br />(Phone) <br />SERVICES OR MATERIALS FURNISHED BY CLAIMANT: ___.__._S. ---- ---- <br />---------------------------------------------------------------------------------------------------------- --------- - - - ---- ------------------ ---------- -- ....... <br />CONTRACT PRICE: $ ........... ............. — --------------------------- AMOUNT UNPAID: $ ---- --- <br />------------ --- � 3 <br />TIME LAST SERVICES OR MATERIALS FURNISHED: ........ - - - ----------------- <br />State o f <br />--------- ----------- <br />...... I ------------------- <br />SS.- -------- -/ --------------- ---- -- ----------- <br />--------- Sinature of Claimant <br />----------- ------------------------ County � <br />On this ----- /Va 4��; <br />------------------ day of .......... ----------------------------------------------------------- - -------- - before me a Notary Public in and for <br />said county, personally came ---- T kl- F_- :--) - - -- -- <br />------------ --------- to me known to be the identical person or <br />persons who executed ngfrlimpmt. qn knowledged the same to be his, her, or their voluntary act and <br />GENERAL NOTARY - State of Nebraska <br />deed. DENICE R. KRUSE <br />1!!nN My Comm. Fyp. Sent. 25, 20n6 <br />...... 'k ------------------- ----------------------- <br />Notary Public. <br />HL <br />ay ----------- <br />My commission expires the___.___ ....... -------------- d of -------------- ------- <br />STATE OF ----- ---------------------- ------------ ss. Entered on numerical index and filed for record <br />County of ------ -A-1 - ------------------- - --------------------------- I in the Register of Deeds Office of said County the <br />................... day of ----------- I ------------ -- ............. ------------ , at ------------------------------- ------ o'clock and------------ - - - - -- - minutes- -.-. M•, <br />and recorded in Book----- - - - - -- ............. .... of ----- — .................... at page----- - - - - -. --- .._.... -- -- . <br />------------------------ - ------- ----------------------- ---- - ---- ------- Reg. of Deeds <br />By----- ----------------- ----------------------------------------- -------------- - - Deputy <br />■ <br />Jacob %h Prinfinoo4.Mc., Lincoln, NE !W4 <br />2 <br />M. <br />C:) <br />M <br />M I <br />> <br />M C:) <br />ll <br />C- <br />ri-I <br />(f) <br />ZE <br />C�l -n <br />C) <br />L <br />C) <br />7r- <br />VF1 <br />M <br />C) <br />CD <br />C.n <br />(n <br />cn <br />Cn <br />20030403� <br />CONTRACTING OWNER OR SUCCESSOR IN <br />INTEREST: <br />------------------------------ <br />(N a m P,)_. <br />-------------------------------- <br />CLAIMANT: <br />---------------------------------- <br />J <br />(N <br />------ -- ---- ---------------- ------------- ------------ <br />(Addr�so <br />- ------------------------------- <br />----------------------------------- ----------------------------------- ------- - - - - -- <br />(Phone) <br />REAL ESTATE: <br />- ------ ---------- ------- -- - <br />(Legal Desyription) <br />---------- -/--- 1 is--- - - - - -- <br />-------------------------------- <br />CLAIMANT CONTRACTED WITH: <br />(Name) (Zi; 2 ,/e/ L � <br />-------- ------------- ------- ------ --- --- --- <br />(Address) <br />----------------------------------- - - - - ---- --------- ----- -------- — - <br />- ----- - ----- - -------- <br />(Phone) <br />SERVICES OR MATERIALS FURNISHED BY CLAIMANT: ___.__._S. ---- ---- <br />---------------------------------------------------------------------------------------------------------- --------- - - - ---- ------------------ ---------- -- ....... <br />CONTRACT PRICE: $ ........... ............. — --------------------------- AMOUNT UNPAID: $ ---- --- <br />------------ --- � 3 <br />TIME LAST SERVICES OR MATERIALS FURNISHED: ........ - - - ----------------- <br />State o f <br />--------- ----------- <br />...... I ------------------- <br />SS.- -------- -/ --------------- ---- -- ----------- <br />--------- Sinature of Claimant <br />----------- ------------------------ County � <br />On this ----- /Va 4��; <br />------------------ day of .......... ----------------------------------------------------------- - -------- - before me a Notary Public in and for <br />said county, personally came ---- T kl- F_- :--) - - -- -- <br />------------ --------- to me known to be the identical person or <br />persons who executed ngfrlimpmt. qn knowledged the same to be his, her, or their voluntary act and <br />GENERAL NOTARY - State of Nebraska <br />deed. DENICE R. KRUSE <br />1!!nN My Comm. Fyp. Sent. 25, 20n6 <br />...... 'k ------------------- ----------------------- <br />Notary Public. <br />HL <br />ay ----------- <br />My commission expires the___.___ ....... -------------- d of -------------- ------- <br />STATE OF ----- ---------------------- ------------ ss. Entered on numerical index and filed for record <br />County of ------ -A-1 - ------------------- - --------------------------- I in the Register of Deeds Office of said County the <br />................... day of ----------- I ------------ -- ............. ------------ , at ------------------------------- ------ o'clock and------------ - - - - -- - minutes- -.-. M•, <br />and recorded in Book----- - - - - -- ............. .... of ----- — .................... at page----- - - - - -. --- .._.... -- -- . <br />------------------------ - ------- ----------------------- ---- - ---- ------- Reg. of Deeds <br />By----- ----------------- ----------------------------------------- -------------- - - Deputy <br />■ <br />