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Claim of Lien 200505593 <br />.......................................................................................................................... ............................... <br />State of C S <br />County of V1)—A— <br />Before me, the undersigned Notary Public, personally appeared �.ecD�� <br />who cl I swo n sa s that he is (the lienor he ein) (the a ent of the lienor herein) hos ad ress is <br />Y � Y <br />(� I'� V -�c'_S eq S� <br />and that in accordance with a contract with , v A 4-- rs <br />lienor furnished labor, services or materials consisting of: (Describe specially fabricated materials <br />separately) <br />on the following de :ribed rea property in �- �— County, <br />State of �J <br />(Desc 'be real property sufficiently for ident i ation, includin street and number: <br />iLL'— „ir,.>ir.•��lrl!i+�.l w � _,� ���1f 1�i�n���t"1'��” ': :fir <br />by 'WAL -- myfA Q-Qa1 � O -kp I &ISI l( e-ss A iv <br />total value of <br />of which there remains unpaid l ✓ . N 19-rq 5!4 r4 e t Ip7e TU Foe <br />and furnished the first of the items on 5/A3 0 5 <br />items on , 20 <br />not in privity with_the owner) Vt the lie or served Iis �otice to wner on <br />20 by e V `� ' I az <br />(Method of Service) <br />And, (if required) that the lienor served copies of the notice on the contract on <br />20 . by <br />(Method of Service) <br />on 20 , by <br />lender on by <br />-)6 Y AAck�e verve <br />mro necgo, ' S , <br />Page 1 <br />KI <br />Z., 1 or a <br />Dollars ($ ) <br />ita—rs (s <br />20 e S and the last of the <br />_ and (if the lien is claimed by one <br />�Z� <br />C) CC <br />and on the subcontractor <br />and (if known) on the <br />(Method of Service) <br />www.socrates.com ® 2004, Socrates Media, LLC <br />LF136 • Rev. 04/04 <br />