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<br />RETURN TO: 0 "~&vw-
<br />Thomas L. Saladinb'-'-"
<br />Fitzgerald, Schorr, Barmettler & Brennan, P.c., L .0,
<br />13220 California Street, Suitc 400
<br />Omaha, Nebraska 68154
<br />
<br />200510745
<br />
<br />(SPACE ABOVE THIS LINE FOR RECORDING DATA)
<br />CONSTRUCTION LIEN
<br />
<br />1. The real estate subject to this lien is: A portion of the property located at the Northwest
<br />Corne.' of Old Potash and Webb Roads/ Highway 281 and Old Potash Read, Grand Island. NE,commonly
<br />known as 221 Wilmar Avenue, Grand Island. Nebraska legally described as Lot 2 of Martin's Third
<br />Subdivision and part of the SEl/4, SE Y.., Section 13, Township II North, Range 10 West in the City of Grand
<br />Island, Hall County, Nebraska.
<br />
<br />2. The name and address of the person against whose interest in the real estate this lien is claimed
<br />are: Kohl's Department Stores, see real estate address above.
<br />
<br />3. The name and address of the claimant are: MID-PLAINS INSULATION COMPANY, INC..
<br />14614 GROVER STREET, OMAHA, NE 68144.
<br />
<br />4. The name and address of the person with whom the claimant contracted are: Preisendorf
<br />Plumbing & Heating, Ine, 1104 W. Oklahoma Avenue, Grand Island, NE 68802.
<br />
<br />5. A general description of the claimant's services performed or to be perfonned or materials
<br />furnished or to be furnished for the improvement is: Insulation of HV AC ducts and plumbing.
<br />
<br />6. The contract price is: $17,900.00.
<br />
<br />7. The amount unpaid, whether or not due, to the claimant for the services or materials is:
<br />$17,900.00.
<br />
<br />8. The date the last services or materials were furnished was: August 2, 2005.
<br />
<br />MID-PLAINS INSULATION COMPANY, INC., a
<br />Nebrask, a .,c,orporation jJ (/)
<br />
<br />BY~7,d,~
<br />
<br />STATE OF NEBRASKA)
<br />) SS.
<br />COUNTY OF DOUGLAS)
<br />
<br />SUBSCRIBED and sworn to before me this 2" da);
<br />
<br />
<br />ed"r-.. -;!!:/~ tu~y-
<br />
<br />,
<br />
<br />
<br />GENERAL NOTARY. State 01 Nebraska
<br />STEPHEN SCOTT WEEKLEY
<br />My Comm. Exp. March 17, 2008
<br />
<br />201095-1
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