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<br />INSTRUCTION LIEN
<br />
<br />Jacob North Printing Co., Inc., Lincoln, NE 68524
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<br />200511248
<br />CONSTRUCTION LIEN
<br />
<br />1. The real estate subject to this lien is: ---.Lot.
<br />Hall County, Nebraska
<br />
<br />~nn ? rpdar Ridge 2nd SYs.,
<br />
<br />2. The person against whose interest in the real estate the lien is claimed is:
<br />Joel Shafer d/b/a Midwest Builders
<br />
<br />3. The name and address of the claimant is: MinlATP~t Sheet Metal Company, Ino.
<br />
<br />d/b/a Midwest Heating & A/e, 2304 W. Lincoln Hwy., Grand Island, NE
<br />6880
<br />
<br />4. The name and address of the person with whom the claimant contracted is: Mi OlATE'st B1lilders
<br />
<br />819 N. Di~rR Avp_, Sqite 1, Grand Island. NE 6gg03
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<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: F'<:lbrica te ductwork, oonnect
<br />
<br />and start UP apartment units. Repair leaks.
<br />
<br />6. (Complete one of the following)
<br />
<br />~ The amount unpaid, whether due or not, to the claimant for the services or materials is $
<br />
<br />-----X- The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $14 . :2 9:2 . 14
<br />
<br />7. (Complete one of the following)
<br />
<br />~ The time the last services or materials were furnished was
<br />
<br />July 15, 2005
<br />
<br />~ The time the last services or materials were furnished has not yet occurred but is estimated to occur
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<br />l,;l ~"- day of 0 < "CL ' da>~..
<br />;~,l~QA~ O"~-.
<br />Notary Public
<br />
<br />Subscribed and sworn to before me this
<br />
<br />(52-147. See 52-148 for amendment; 52~ 149 for assignment; 52.137 for recording time; 52.154 for discharge or release).
<br />
<br />111----
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<br />Rev~---:-
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