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<br />ISTRUCTION LIEN <br /> <br />Jacob North Printing Co., Inc., Lincoln, NE 66524 <br /> <br /> ;0 n ~ <br /> 0~r m :J: <br /> -n <br />'" t-1~ c: ~ ~ <br />S Z ::x: c.;:.:;) o (fJ <br />s n ~ ".:::;0 <br />en 9J E 0 O? o -I <br /> % ::~ c:> <br />s - m ~ ~.- z-l <br />S L- ~f <br />en m (TI ~ n f) = -l1Tl <br />-....J ' r 2 ~ ::c :z:: -<0 <br /> 0- <br />ex:> c: ~" N o-n <br /> ~' U' j 0 c..n ""'z <br /> 0 ..." <br /> (i~ l' f 0 tk ::r: 111 <br /> (;0 , m -0 );>o.o:J <br /> S J) m t ::3 r::o <br /> 0 ,P- <br /> if) if) <br /> r-v A <br /> ~ P- <br /> O ........."~ <br /> 200600678 w en <br /> U3 <br /> CONSTRUCTION UEN <br /> <br /> <br />1. The real estate subject to this lien is: ~DQ. W K ,'01 boll ,:lv'€. () r Ltn '~n <br />Pat!1 ~l (, Pal \ u \'\'1 Coo g Stuwnd Ack1 f 3' 0+ S ~t;, I L T 70/.- All L.T8 <br /> <br />2 Th B L-t< I a5 h" . halt te th l' " I" ed' <br />. e person agamst w ose mterest m t e re es a e len IS c rom IS: <br /> <br />CJ i -\4:0\d P. F J (l.na. Cja.n <br />3. The name and address of the claimant is: Dllr'lll -td a.xt se.n cJ/ b / a... \V Ddckn D <br />3~:.l. E Q.S-+ 9#1Si-re~'t Gro..nd :rs/and. 1J E bf'JD / <br />, <br /> <br />4. The name and address of the person with whom the claimant contracted is: <br /> <br />c.,\~~D'('d rr\~ 3(d)O S 7G~St L'I1lU>ln/AJi=" <br /> <br />I <br />6tf6d-6 <br /> <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: <br /> <br />0.on~\Dn ffi).i.ex.ldils J inclu.d;nj-Lbli~nf>'4- l,'m,' +e d -1-0) y/U ~ IJoui~ <br /> <br />'()~W doo'fS, ~ ~lf-pplJ'-es; eJlec.4-t-I'ULl ?:,urrll'es,W Inc1()w~> roof,~ <br />, In'lo....U-r, ~.I.bJ I "a <br />6. (Complete one of the follOWing) .....; $ 00 <br /> <br />~ The amount unpaid, whether due or not, to the claimant for the services or materials is $ ?S-) t;oO . <br /> <br />_ The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ <br />-\,1.- <br />7. (Complete one of the following) ;< 5 7' <br /> <br />~ The time the last services or materials were furniBhed was ~ ~ J .flOOt, . <br /> <br />_ The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br /> <br />Subscribed and sworn to before me this <br /> <br />ant 'AlVA, {}-. /!/f,/lJf6R" /j <br />cJUI /O,6L OF t1J~.;Jt-;/I/ <br /> <br /> <br />a2fFd.- dayof 9~. O~ <br /> <br />cJC.-? .-r4.--'" ..; /c2, 14-z"",~ - ~ <br /> <br />Notary Public <br /> <br /> <br />GENERAL NOTARY - State of Nebraska <br />DENICE R. KRUSE <br />My Comm. Exp. Sept. 25, 2006 <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 />Ii i <br /> <br />~>_'..,'...___ _---1. <br />i <br />Rev. 9/951 <br /> <br />j II <br />1~-~n"'" . <br />.. ru r--- <br />d <br />N <br />~ <br />d <br />~ <br /> <br /> <br />(l <br />"0 <br />n <br />.J <br /> <br />II <br /> <br />, <br />,. <br /> <br />II <br />I <br /> <br />rr~ <br />