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<br />, I <br />j' <br />...._ '.__._,.' __"..__.._._.........L____ <br /> <br /> Jacob North Printin Co. Inc. Lincoln NE 68524 ;1 <br /> 1 t <br /> i' <br />n n ! 1 <br /> (...".,> <br />:I: >- ~ n {f1 <br />m (I) c::> <br />n ::J: "-"':1- ~ 0 -l <br /> c: > <br />A ....~-\ ... c- Z -l <br /> ;::0 e' c:::: <br /> r- -1fT! <br /> V'\ ~ ;-,.i: -< 0 <br /> o~ I-' 0 "T] <br /> ~ ,., -C "T] :z: <br /> l"? U. ::r: In <br /> iTl r ::0 I>' cn <br /> f'TI ::3 I ;;0 <br /> 0 I :t> <br /> Ul ........ C/J <br /> m ;:>;: <br /> :r> <br /> ...::: -- <br /> CD CA <br /> fA <br /> <br /> <br />~STRUCTION LIEN <br /> <br />EO:> <br />--(\ <br />-;- <br />-+ <br />\:)~ <br />_.- <br /> <br />F-~ <br />{~ <br /> <br />70 <br />m <br />-n <br />c: <br />Z <br />Qno <br />m)>(I) <br />R~ <br /> <br />J\.) <br />S <br />S <br />0') <br />S <br />0') <br />J\.) <br />(J'J <br />J\.) <br /> <br />200606252 <br />CONSTRUCTION UEN <br /> <br />.s: 50 <br /> <br />1. The real estate subj~ to this lie <br />~ <br /> <br />2. <br /> <br />3. The name and address of the claimant is: <br />- / tf. <br />~(.,.., l{/ e $" 1 /~ 9 -r, <br /> <br />$a .r /f'it11 (j i/C <br /> <br />4. The name and address of the person with whom the claimant contracted is: <br />/" / c", . <br />(...:P-Ct.-yC1J.1. (,7' ',' - ,'I"(. i Ct 5' -/~V 7' <br />$"& I /Yfa." tJ /,,4.--r:'He .. v ~ Pl..' f e / ~ en; /,'// i.-zr1, / {A, )I'd "" <br />5. A general descritftion of the claimant's services performed to, to be performed or materials furnished or to be <br />furnished for the imp:ovem~9- the contract price is: <br /> <br />/}~ fl/d 7;41r0/ ~- e ;# 5j {t ~ <br />/11 I! '- tl/J()60 D () 5:.:;Lb ~ <br />I .. <br /> <br /> <br />6. (Complete one of the following) 5It <br />L The amount unpaid, whether due or not, to the claimant for the services or materials is $ 5;/ f:' , ~ <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 />1 The time the last services or materials were furnished was ~11' J I ;,2;:;;? t:J ti6 <br />~ The time the last services or materials were furnished has not yet occurred but is estimated to occur <br /> <br /> <br /> <br />and sworn to before me this <br />G8iRAL NOTARY w Slate of Nebraska <br />DARREN SANCHEZ <br />Comm. . 24 2008 <br /> <br />,:2~. <br /> <br />(52-147. See 52-148 for amendment; 52-149 for assignment; 52-137 for recording time; 52-154 <br /> <br />,:r:; v't1 ; ~ c; ;f Y;;< t/ t" <br />~ Ie .,~ .c 5' <br />........--- <br />My rt1r!.5 <br /> <br />.$75' Ii'fl.rzr <br /> <br />~5o <br /> <br />cPs:' d-~ <br />~-_..'" <br />~At- v-'7,!,t'l <br />I (J - (Ill , _ <br />---4;2~~Ai~~~~c:~/;:~f~or.It... <br /> <br /> <br /> <br />; . <br /> <br />, i <br /> <br />i ~ <br /> <br />; :. <br /> <br />-: ~ <br /> <br />i i <br /> <br />Qf 4.ql'-Cz~i'l!~~5 C";C <br /> <br />Rev. 9/9 <br />