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145- CONSTRUCTION LIEN <br />N � <br />V, <br />Jacob North Printing Co., Inc., Lincoln, NE 68524 <br />� <br />G <br />�'s U <br />H o <br />-n <br />m C11 <br />n :L <br />N <br />iY <br />,:' ; <br />C7 (p <br />p <br />c:D <br />cr <br />CL <br />CD <br />Cn <br />C.0 <br />CP <br />CONSTRUCTION LIEN <br />CP <br />1. The real estate subject to this lien is: I a 03 C_e—c)L"/ tC i UCH C ( Qty , } <br />S`. S0 <br />2. The person against whose interest in the real estate the lien is claimed is: t c r <br />3. The name and address of the claimant is:- <br />-::S ,4 v "'12 , n 1 <br />4. The `name and address of the person with whom the claimant contracted is: t <br />(rl ' r `j Ac,,ie L, <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: i A 4k 1) e <br />L., ,- -I <. 4 . I;f <br />6. (Complete one of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ 5 �� <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 LI " �),� - 05 -- . <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />y � <br />Signat re of Claiman <br />Subscribed and sworn to before me this day of��� <br />GENERAL NOTARY - State of Nebraska <br />VALERIE MELSEN Not ry Public <br />*comm. Exp, Aug. 20, 2009 <br />(52 -147. See 52 -148 for amendment; 52 -149 for assignment; 52 -137 for recording time; 52 -154 for discharge or release). <br />Rev. <br />