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<br />~ <br />~\ W -.C> <br />';:t v '-l ~. <br />~ \J\ S- <br />~ ~,~ <br />~ <br />~~~ <br />~ ~ <br />~ <br />~.~~ <br />~ -~' <br />~ ~ <br /> <br />t"l <br />~~ <br />n(l) <br />~::t: <br /> <br />J___JJ__ <br />.'."--"r--II <br />i <br />- --- - --------- ---"-~-- Jacob _~orth Printing Co., Inc., Lincoln, NE 68524 -1' ___ <br /> <br /> <br />~ nn ~ O(fl <br />q:: ::I: > ~ 0 -i <br />c: ~ ~ ~::3!:; :::; ! <br />z " ;;;Om~'::;::O ~ fT1 ! <br />o -= -<0 <br />C/) G -........ o""Tl <br />O' ........ ""Tl Z <br />7'-~ ::r: fT1 <br /> <br />~r ~ ~~ <br />~ ~ ---- <br /> <br />........ <br /> <br /> <br />~STRUCTION LIEN <br /> <br />(fJ <br />(fl <br /> <br /> <br />N <br />cSl <br />S <br />0) <br />S <br />.f::>. <br />....... <br />(0 <br />-..J <br /> <br />() <br /> <br />CONSTRUCTION UEN <br /> <br />200604197 <br /> <br />1. The real estate subject to this lien is: 1.-6+ 3 q I V\J I (l-f)h.f1CLd Sa..b <br />tf/38 Ill../}/t1iA jz.Pt1 d Dr. LJ '(fi,l/\d ~ Ia..--li\a <br /> <br />2. The person against whose interest in the real estate the lien is claimed is: .a;::; , 1.e4'\ ern J ktd-iu./ <br />~/ve,rtL J <br /> <br />3. The name and address of the claimant is: t< 1+C' h";>J\ 4' &JL /J l\. i,Y)")d-ed. ~ n c.. <br />_Pb. (0)( rq &111.5, Nz. ~ <{6J.,O <br /> <br />4. The name and address of the person with whom the claimant contracted is: 2.f V\ OYI J k 0. -{ tu. j <br />J<.i 0~,((J.... t.//38 Jitdi(1.tUuad Or GraAtd 7S~-Ad. <br />I <br /> <br />s: <br /> <br />cJ <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 />Ca.-b\f\€_~fj a Y\d IlLm'If\.a1~ (iOLAIt\{oLV -fep <br /> <br />6. (Complete one of the following) <br />~ The amount unpaid, whether due or not, to the claimant for the services or materials is f II) /57.. 3" <br />_ The unpaid amount is not fixed by the contract, but a good faith estimate in the amount of $ <br /> <br />7. (Complete one of the following) <br />~ The time the last services or materials were furnished was f-i>_\I\.-. 1:5 I 1. one., <br /> <br />_ The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br /> <br />GBERALImMlY . SIIII of <br />CORINNE'" kI: II SAUNG <br />il,c:... lip. 0CnElt. 2006 <br /> <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 />i i i <br /> <br />Rev. 9/9~ <br />