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- -- 1.1.....1._ <br />li l 145 - CONSTRUCTION LIEN <br />m <br />CJ1� <br />Q <br />C n ....� <br />Jacob North Printing Co., Inc., Lincoln, NE 68524 <br />1. The real estate subject to this lien is: ti o Z �� <br />1 �0,6TC <br />2. The person against whose interest in the real estate the lien is claimed is: 0 C, &+At1,.-CZ- : M4Af S hZ <br />3. The name and address of the claimant is: S� OK 7" <br />� q- , (A <br />4. The name and address of the person with whom the claimant contracted is: TDr- V2 l w�-La <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: j <br />BI O �K, V o C. <br />17 A J Q-/ C"tl\ LT V,) <br />6. (Complete one of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ 611 W - 00 <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 />x The time the last services or materials were furnished was 51t 7 I o' 5 <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />Subscribed and sworn to before me this <br />GENERAL NOTARY - SW of Nebraska <br />STACEY A. RUZICKA <br />My Comm. EV. May 10, 2007 <br />Signature of Claimant <br />A "<\ <br />—day of a r�ti <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 />Rev. 9/91 II <br />Z n = <br />C> eq <br />c--7 <br />:C <br />P71 <br />M. <br />CD <br />Cb <br />200508165, <br />CONSTRUCTION LIEN <br />1. The real estate subject to this lien is: ti o Z �� <br />1 �0,6TC <br />2. The person against whose interest in the real estate the lien is claimed is: 0 C, &+At1,.-CZ- : M4Af S hZ <br />3. The name and address of the claimant is: S� OK 7" <br />� q- , (A <br />4. The name and address of the person with whom the claimant contracted is: TDr- V2 l w�-La <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: j <br />BI O �K, V o C. <br />17 A J Q-/ C"tl\ LT V,) <br />6. (Complete one of the following) <br />The amount unpaid, whether due or not, to the claimant for the services or materials is $ 611 W - 00 <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 />x The time the last services or materials were furnished was 51t 7 I o' 5 <br />The time the last services or materials were furnished has not yet occurred but is estimated to occur <br />Subscribed and sworn to before me this <br />GENERAL NOTARY - SW of Nebraska <br />STACEY A. RUZICKA <br />My Comm. EV. May 10, 2007 <br />Signature of Claimant <br />A "<\ <br />—day of a r�ti <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 />Rev. 9/91 II <br />