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~"=~Jl " I -#-- 223 CONSTRUCTION UEN Huffman and Felton & Wolf, Walton, Ne 68461 ,i . ~ CONTRACTING OWNER OR SUCCESSOR IN INTEREST: REAL ESTATE: :1 ',1 'i i q d 1l 200605720 ----......~.O.a_~3_S-2.~Oi.6.5---------------.-..........-------------------------------- (Phone) ___.EMP___De.ve_~o.pment---------------------------------_____________________ (N ame) ...... .... -- -. - --P-.. -O-.-Box--- -1-5-7-1............... - --- - -- - - -- - -- - - - --- - - --- - - - - --- ---- (Address) -----------.....Gra:nd--Ts-l-a-ndmN-e--~----6-8-a_02~.1.5.71m 308-379-7881 --_...............--....----------------------------_.................------------------------------------ (Phone) ! i ,( q :\ H H II il II :I ; ~ I ~ ~ i -! .._mm_~_~~____[)_~.~~_~_?.PI1l_e:_~~........b..b.~m_m________m__m (Name) ..... __ __ _P_._Q_ .__ ___:So 9.;>.<;:._. J_ 5_.7.1_ __ ___ _............ - .__ - -- - ---- --- ---- ----- ---- -- -- ---- -------LQ.t....#.2----P-lea-s-antmView----1-3-th..............-.-- (Legal Description) __........Grand___Isl.and___N_e_,.....6.8.802_..._15.7_L___------ ____._.111.6....Ja_c_ks_Qn___St_,___________________________ CLAIMANT: CLAIMANT CONTRACTED WITH: mmmO__'__Har_amPlumbingmCO'...m_In.c...............___..____ (Name) .......__P_.._O_.____Box.__-l_0-38______...........______-------------------------------- (Address) ---------Grand----r-5-1-and.;..--Ne-~------..6'88.0.2.~ltn-a--- " II Ii SERVICES OR MATgRIALS FURNISHED BY CLAIMANT: PLumbing ~ I CONTRACT PRICE: $_____~_L~_~A.....9..9.m___mm___m_mm AMOUNT UNPAID: $__J_,_~_~_~_.__~.9................_______.__ !i :i " q 1\ d :i !I iI ;; ----_..........--------------_._..........-.-.-------------_..............-.---------------------------------------------------_............--.-------------------------------_............-..-..--.--- ----------------------------------- _.........---.--------------........-.-.--------------._...........------------------------------------..-----..-.----..-.......--..--------------------------------.-...........-.-------------------- ---------------------------..--.... :j ! TIME LAST SERVICES OR MATERIALS FURNISHED: __m~_!.~..?/.Q_~.,_____m____mm__>'-.............".---mmm--m---m--m--m-----------------.. mm 'm'~7 LL<-/'mmmmmmmmmmm Sign~ '1M k...0 'HiCI.L,<> C\ t.J-iNP '2 On this m--2-7............. day of --J-t:me..-m.........-----mm--mmmmm2-00-6-m-mm , 19 .._.____ , before me a Notary Public in and for State of mmNeb-raS-ka--m.....-m-m--mm\ ___m___Ha:l.l...._mm_mm__...........___m_County ss. persons who executed the foregoing instrument, and acknowledged the same to be his, her, or their voluntary act and deed. GENERAL NOTARY . SlldII of NebraSka KATHRYN A. MIlLER My Comm. Exp. Dec. 15, 2001 m___m~_~.~.:m _~_~mm{J_'____~m_mmm__'...____ ~ Notary Public. I'! !i q II :1 i H l ~ Ii said county, personally came ..___.m_.Jack___D-_'__Hara__.__.__.m__.._..........,..m__mmm_m__ to me known to be the identical person or ____m___mm__._......____________m__m_...........__mmm__m_m..Reg. of Deeds By ....___m__m__mm_.............__mm_mm_m..............mm__________ Deputy ,: :i p I I II il :1 q II :1 'I I ~ My commission expires themJ5-!~.....n___day oLh_e_~<?,.'f.n..b_e__'C___________,Zs!.Q.7--. STATE OF --N-e..b.:cQS-};,-Q.,.........--m--mm----......l Entered on numerical index and filed for record County of ...nH_~.lL.....__.______m__m__....n____m__m_m__ ss, in the Register of Deeds Office of said County the ..__m___________..day ofm.. ..........._m__mm_____ _...__, 19____m__m' at.......... ....._________m__m_m__O' clock and____.............m____ minutes.......... ..______M., and recorded in Bookmm........________mm_of........m__._______m__m_at pagemm.......__..__mm_____. 'i I :1 ;( !I !! i ! '! i J _ =----- --~,~-----~_.. ..,