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223 CONSTRUCTION LIEN C C _. �` Jacob North Printing Co., Inc., Lincoln, NE 68524 200312185 CONTRACTING OWNER OR SUCCESSOR IN INTEREST: I - I _T_ V L_,1 + (Name) ------- ---------- -------- ------- -------- - ----- --- -------- ------------- ---------------- --- CLAIMANT: REAL ESTATE: x.L -hurl _4 - -- -- I - .& ------------------ ------------ (Legal beiXqon� -------------------------------- � I I X1111..1 -. -.1- &AJ, -C.j.,l ------------ CLAIMANT CONTRACTED WITH: r,c --------------- ------------------ - - ---------------- - ----- (Name) (Name) ---- ---- -- -------------- -- --- -- --- - --- ---- --------------------- ----- -- --- (Address (Address J.i C i ------- ---- - -------- ------- -- - - -- - - - - -- -- --------- -------------- --- -- - - -- ---- ---- --- --- - - - - -- (Phone) (Phone) SERVICES OR MATERIALS FURNISHED BY CLAIMANT: ...... -------- --------------- 1 A--- ------ .. ..... __A i I"(_,_ ------ . ....... -------- -------- - - -------- --- ------------- --- --- - ----------------- - - - - -- --- ----- - -- - - - ---------- --------------- ------ --- - - ----- - --- ----- ---------- AMOUNT UNPAID: ----------- __ -------- CONTRACT PRICE: I - --- --------------- ------------------- - ---- -------------------- -- -------- TIME LAST SERVICES OR MATERIALS FURNISHED: ---- ------ State of ...... --- ..... �Ss. - -- - -- ---- ---------- ------ h -- ---- --------- - - ------- County Signature of Claimant On this day of ------- ..... . before me a Notary Public in and for ,P, W__ --- --- -- --------- - - ----- ---- AL said county, personally came gual& -------------- _ ----------------------- to me known to be the identical person or persons who executed the foregoing instrument, and acknowledged the same to be his, her, or their voluntary act and deed. My State of Nebraska LORI SN YD ER Comm. Ex Ma 1, 2 004 ------- - 1 -0- - ---P, y -- - Notary - P --- u-blic. My commission expires the__._.... I ';-t ------ day of ---- XP_ y ------------------- ---- -- I )jj 4 STATE OF ------ - ------- ---- ----- - - ----- Entered on numerical index and filed for record ss. County of _. -ilul—) __ - - ____ - ___ - ___ - - - - in the Register of Deeds Office of said County the ...day of_...... --- --------- _ -------- ---- I ----------- I at------ - - - - -- - ---------------- - -- o'clock and - - - - -- ---- ---------- minutes - - ----- --------- M., and recorded in Book - ---------- -- -------- .--of --- ----------------- - -- - -at page ---- - ----------------- ----- ------------------ ----- -- -------- --------- -- ----- --------------- - ------ Reg. of Deeds By - - - -- -- --- - - - - -- - - - - -- --- - - - - -- -------------- - ---- -------- --------- Deputy Rev. 8/95 rill > rT T1 r7i c /) C-) C:7 r) X- r-o Q1 T1 M ❑ M CD CD Cil t 1 :Z" rn rTl C" M _Z3 C', CD CD co =3 0) Ul F" Cf) 200312185 CONTRACTING OWNER OR SUCCESSOR IN INTEREST: I - I _T_ V L_,1 + (Name) ------- ---------- -------- ------- -------- - ----- --- -------- ------------- ---------------- --- CLAIMANT: REAL ESTATE: x.L -hurl _4 - -- -- I - .& ------------------ ------------ (Legal beiXqon� -------------------------------- � I I X1111..1 -. -.1- &AJ, -C.j.,l ------------ CLAIMANT CONTRACTED WITH: r,c --------------- ------------------ - - ---------------- - ----- (Name) (Name) ---- ---- -- -------------- -- --- -- --- - --- ---- --------------------- ----- -- --- (Address (Address J.i C i ------- ---- - -------- ------- -- - - -- - - - - -- -- --------- -------------- --- -- - - -- ---- ---- --- --- - - - - -- (Phone) (Phone) SERVICES OR MATERIALS FURNISHED BY CLAIMANT: ...... -------- --------------- 1 A--- ------ .. ..... __A i I"(_,_ ------ . ....... -------- -------- - - -------- --- ------------- --- --- - ----------------- - - - - -- --- ----- - -- - - - ---------- --------------- ------ --- - - ----- - --- ----- ---------- AMOUNT UNPAID: ----------- __ -------- CONTRACT PRICE: I - --- --------------- ------------------- - ---- -------------------- -- -------- TIME LAST SERVICES OR MATERIALS FURNISHED: ---- ------ State of ...... --- ..... �Ss. - -- - -- ---- ---------- ------ h -- ---- --------- - - ------- County Signature of Claimant On this day of ------- ..... . before me a Notary Public in and for ,P, W__ --- --- -- --------- - - ----- ---- AL said county, personally came gual& -------------- _ ----------------------- to me known to be the identical person or persons who executed the foregoing instrument, and acknowledged the same to be his, her, or their voluntary act and deed. My State of Nebraska LORI SN YD ER Comm. Ex Ma 1, 2 004 ------- - 1 -0- - ---P, y -- - Notary - P --- u-blic. My commission expires the__._.... I ';-t ------ day of ---- XP_ y ------------------- ---- -- I )jj 4 STATE OF ------ - ------- ---- ----- - - ----- Entered on numerical index and filed for record ss. County of _. -ilul—) __ - - ____ - ___ - ___ - - - - in the Register of Deeds Office of said County the ...day of_...... --- --------- _ -------- ---- I ----------- I at------ - - - - -- - ---------------- - -- o'clock and - - - - -- ---- ---------- minutes - - ----- --------- M., and recorded in Book - ---------- -- -------- .--of --- ----------------- - -- - -at page ---- - ----------------- ----- ------------------ ----- -- -------- --------- -- ----- --------------- - ------ Reg. of Deeds By - - - -- -- --- - - - - -- - - - - -- --- - - - - -- -------------- - ---- -------- --------- Deputy Rev. 8/95